Postoperative pneumoperitoneum: is it normal or pathologic?
BACKGROUND
Pneumoperitoneum on computed tomography (CT) after abdominal surgery is common, but its incidence, duration, and clinical significance is widely debated.


METHODS
A retrospective, cohort study of patients who underwent abdominal CT within 30 days of abdominal surgery.


RESULTS
Among 344 patients, pneumoperitoneum was found in 39% (135/344) of patients on postoperative days 0-6 in 53%, 7-13 in 41%, 14-20 in 23%, 21-27 in 13%, and 28-30 in 0%. Pneumoperitoneum was associated with the presence of a drain (P = 0.014) but not with age, gender, body mass index, smoking history, lung disease, or open versus laparoscopic surgery (P > 0.05 for all variables). Eight patients required intervention (6%), most commonly for anastomotic leak (4 patients, 50%).


CONCLUSIONS
Postoperative pneumoperitoneum on abdominal CT can be seen in up to 23% of patients 3-weeks postoperatively; however, only 6% of the patients required intervention emphasizing the typically benign consequences of postoperative free air.
Department of Surgery, University of Colorado at Denver, Aurora, Colorado.
Brandon C
BC
Chapman
University of Colorado Hospital, Aurora, Colorado.
Kelsey E
KE
McIntosh
Department of Surgery, University of Colorado at Denver, Aurora, Colorado.
Edward L
EL
Jones
Department of Radiology, University of Colorado at Denver, Aurora, Colorado.
Daniel
D
Wells
Department of Surgery, University of Colorado at Denver, Aurora, Colorado.
Greg V
GV
Stiegmann
Department of Surgery, University of Colorado at Denver, Aurora, Colorado. Electronic address: Thomas.Robinson@ucdenver.edu.
Thomas N
TN
Robinson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003120:Colorado; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
Free air; Pneumoperitoneum; Postoperative