True incidence and clinical significance of pneumoperitoneum after PEG placement: a prospective study

Recurrent tense pneumoperitoneum due to air influxviaabdominal wall stoma of a PEG tube

“…Various complications such as skin site infection, bleeding, hematoma formation, aspiration, perforation and pneumoperitoneum are common (Table 1) [1] . Pneumope ritoneum was noted in 8.6% of the PEG tube placements in a retrospective analysis [2] .…”

Percutaneous Endoscopic Gastrostomy in Neurological Patients

“…Clinicians should maintain a high index of suspicion for nonsurgical causes of pneumoperitoneum and should recognize that conservative management may be indicated in many cases (Mularski et al, 2000). In one study of patients undergoing PEG placement, of the 65 patients who underwent PEG placement, 13 developed a pneumoperitoneum on the initial chest radiograph; 10 of the 13 patients experienced complete resolution of pneumoperitoneum at 72 hours, and in 3 patients, the free air persisted but was of no clinical significance (Wiesen et al, 2006). Wiesen et al conclude that pneumoperitoneum following PEG is of no clinical significance and hence, does not warrant any further intervention (Garcia-Bueno et al, 1998;Wiesen et al, 2006).…”

“…In one study of patients undergoing PEG placement, of the 65 patients who underwent PEG placement, 13 developed a pneumoperitoneum on the initial chest radiograph; 10 of the 13 patients experienced complete resolution of pneumoperitoneum at 72 hours, and in 3 patients, the free air persisted but was of no clinical significance (Wiesen et al, 2006). Wiesen et al conclude that pneumoperitoneum following PEG is of no clinical significance and hence, does not warrant any further intervention (Garcia-Bueno et al, 1998;Wiesen et al, 2006). Replacement is sometimes required if a PEG is inadvertently removed; premature removal of PEG tubes by either the patient or healthcare staff occurs in 2% of patients and can lead to significant complications if not promptly recognized and appropriately treated (Galat et al, 1990;Larson et al, 1987;Marshall et al, 1994;Orlando Regional Medical Center Department of Surgical Education, 2009).…”

Modificação de dispositivo para gastrostomia endoscópica percutânea pela técnica de punção: utilização em pacientes com neoplasia maligna de cabeça e pescoço

“…A causa mais comum de "pneumoperitônio benigno" é após a cirurgia abdominal ou laparoscópica sendo que este, geralmente, desaparece em uma semana, podendo durar até 4 semanas 184 . Na ausência de achados clínicos significativos para apoiar doença intra-abdominal, o pneumoperitônio após GEP tem sido considerado benigno e autolimitado 184,185 .…”

“…É consenso que a presença de pneumoperitônio após a realização de GEP é, inicialmente, de tratamento conservador, na ausência de sintomas clínicos 184 . Porém, na presença de sintomas, o uso de estudos complementares como tomografia helicoidal poderia evitar laparotomias desnecessárias 183,187 .…”