TY - CHAP M1 - Book, Section TI - Complications of General Surgical Procedures A1 - Hooker, Edmond A. A2 - Tintinalli, Judith E. A2 - Ma, O. John A2 - Yealy, Donald M. A2 - Meckler, Garth D. A2 - Stapczynski, J. Stephan A2 - Cline, David M. A2 - Thomas, Stephen H. PY - 2020 T2 - Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e AB - Content Update: Post-operative Pneumoperitoneum April 2020Patients undergoing laparoscopic and open abdominal surgery have residual intra-abdominal pneumoperitoneum for varying amounts of time after surgery. Post-operative patients presenting to the ED with abdominal or chest pain may have pneumoperitoneum discovered on CT scanning or upright chest radiographs. Differentiating normal, from pathologic pneumoperitoneum related to perforation or anastomotic failure, can be difficult. Free air may be pathologic if the patient is more than 3-5 days post-op, if there is a large amount of air, or if the patient has evidence of peritoneal irritation, fever, or leukocytosis (1,2,3). For such patients consult surgery to help determine the next steps.(1) Malgras, B et al 'Natural History of Pneumoperitoneum after Laparotomy: findings on multidetector-row computed tomography' World Journal of Surgery 41.1 (2017):56-63 PMID 27456496(2) Gayer, G et al 'Post-operative Pneumoperitoneum as Detected by CT: Prevalence, duration, and relevant factors affecting its possible significance' AbdomImaging (2000) 25:301-305 doi:10.1007/s002610000036(3) Bernstein L et al 'Postoperative Pneumoperitoneum: Clearing the Air' J Surg (Jan, 2014):2 (1), 4. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/04 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1171854170 ER -