title: Pneumoperitoneum post-fluoroscopic percutaneous gastrojejunostomy insertion: computed tomography and clinical evaluation.
abstract: BACKGROUND
  To assess the incidence and clinical significance of pneumoperitoneum after radiologic percutaneous gastrojejunostomy (PGJ) tube insertion.
  
  
  METHODS
  Sixteen subjects were prospectively assessed after imaging-guided PGJ tube insertion to discern the incidence of pneumoperitoneum related to specific clinical signs and symptoms. Computed tomography of the abdomen and the pelvis was performed immediately after PGJ insertion. A clinical evaluation, including history, general and abdominal physical examination, temperature, complete blood cell count, abdominal pain, and abdominal tension, was performed on days 1 and 3, and at the discretion of the nutritional support team on day 7 after PGJ insertion.
  
  
  RESULTS
  Fifteen of the 16 subjects demonstrated imaging findings of pneumoperitoneum after the PGJ-tube insertion. Only a small amount of pneumoperitoneum was demonstrated in 10 of the subjects, whereas a large volume of gas was detected in 2 of the subjects. The only altered clinical findings encountered were increased white blood cell count and fever. These abnormal clinical data were most frequently seen immediately after feeding-tube placement.
  
  
  CONCLUSIONS
  Pneumoperitoneum was a common finding after PGJ-tube placement in our study population. There were no statistically significant abnormal clinical parameters, in the presence or absence of pneumoperitoneum, for any of the subjects after PGJ-tube insertion. Conservative management of pneumoperitoneum after PGJ is warranted.
authors.affiliation: Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Grant
authors.initials: G
authors.lastname: Stoneham
authors.forename: Brent
authors.initials: B
authors.lastname: Burbridge
authors.forename: Jaime
authors.initials: J
authors.lastname: Pinilla
authors.forename: Andrea
authors.initials: A
authors.lastname: Gourgaris
authors.forename: Valerie
authors.initials: V
authors.lastname: Astrope
authors.forename: Heather
authors.initials: H
authors.lastname: Gordon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005471:Fluoroscopy; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D015641:Radiography, Interventional; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome