#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Postoperative pneumoperitoneum


Authors: L. Martínek
Authors‘ workplace: Chirurgická klinika LF OU a FN Ostrava
Published in: Rozhl. Chir., 2026, roč. 105, č. 5, s. 217-220.
Category: Review
doi: https://doi.org/10.48095/ccrvch2026217

Overview

Postoperative pneumoperitoneum is a relatively common finding on imaging examinations after intra-abdominal surgery, and its correct interpretation is of fundamental clinical importance. The key task is to distinguish between clinically insignificant pneumoperitoneum and findings indicating a serious postoperative complication, particularly anastomotic leak or gastrointestinal perforation. The mere presence of free gas in the abdominal cavity is not an indication for surgical intervention; the decisive factors are the clinical situation, dynamics of changes, and correlation with laboratory and imaging findings. The paper summarizes the incidence, natural course, and localization of postoperative pneumoperitoneum, discusses its surgical and non-surgical causes, and evaluates the significance of individual imaging methods, with an emphasis on the high sensitivity of CT examination. Special attention is paid to risk factors and warning signs that increase the likelihood of a complicated course.

Keywords:

imaging methods – postoperative pneumoperitoneum –  complications


Sources

1. Spinelli N, Nfonsam V, Marcet J et al. Postoperative pneumoperitoneum after colorectal surgery: expectant vs surgical management. World J Gastrointest Surg 2012; 4(6): 152 –⁠ 156. doi: 10.4240/ wjgs.v4.i6.152.

2. Horák P, Peregrinová M, Erbenová A et al. Pneumoperitoneum, pneumomediastinum and subcutaneous emphysema fol­lowing argon plasma coagulation treatment of colonic angioectasia. Rozhl Chir 2023; 102(3): 130 –⁠ 133. doi: 10.33699/ PIS.2023.102.3.130-133.

3. Kotek J, Dušek T, Sirový M et al. Pneumatosis cystoides intestinalis as a rare cause of non-surgical pneumoperitoneum. Rozhl Chir 2023; 102(5): 214 –⁠ 218. doi: 10.33699/ PIS.2023.102.5.214-218.

4. Shatari T, Clark MA, Keighley MR. Duration of pneumoperitoneum on chest radiograph after open colorectal surgery. Tech Coloproctol 2004; 8(1): 27 –⁠ 30. doi: 10.1007/ s10151-004-0047-7.

5. Ceydeli A, Fahoum B, Schein M. Delayed post-operative pneumoperitoneum. Dig Surg 2002; 19(5): 420 –⁠ 422. doi: 10.1159/ 000065826.

6. Malgras B, Placé V, Dohan A et al. Natural history of pneumoperitoneum after laparotomy: findings on multidetector-row computed tomography. World J Surg 2017; 41(1): 56 –⁠ 63. doi: 10.1007/ s00268-016-3648-1.

7. Earls JP, Dachman AH, Colon E et al. Prevalence and duration of postoperative pneumoperitoneum: sensitivity of CT vs left lateral decubitus radiography. AJR Am J Roentgenol 1993; 161(4): 781 –⁠ 785. doi: 10.2214/ ajr.161.4.8372757.

8. Chen SC, Yen ZS, Wang HP et al. Ultraso­nography is superior to plain radiography in the dia­gnosis of pneumoperitoneum. Br J Surg 2002; 89(3): 351 –⁠ 354. doi: 10.1046/ j.0007-1323.2001.02013.x.

9. Gayer G, Hertz M, Zissin R. Postoperative pneumoperitoneum: prevalence, duration, and possible significance. Semin Ultrasound CT MR 2004; 25(3): 286 –⁠ 289. doi: 10.1053/ j.sult.2004.03.009.

10. Lee CH, Kim JH, Lee MR. Postoperative pneumoperitoneum: guilty or not guilty? J Korean Surg Soc 2012; 82(4): 227 –⁠ 231. doi: 10.4174/ jkss.2012.82.4.227.

11. Fukuhara S, Egi H, Kochi M et al. The cha­rac­teristics of residual pneumoperitoneum after laparoscopic colorectal surgery. Asian J Endosc Surg 2022; 15(2): 320 –⁠ 327. doi: 10.1111/ ases.13009.

12. Gayer G, Jonas T, Apter S et al. Postoperative pneumoperitoneum as detected by CT: prevalence, duration, and relevant factors affecting its possible significance. Abdom Imaging 2000; 25(3): 301 –⁠ 305. doi: 10.1007/ s002610000036.

13. Peirce GS, Swisher JP, Freemyer JD et al. Postoperative pneumoperitoneum on computed tomography: is the operation to blame? Am J Surg 2014; 208(6): 949 –⁠ 953. doi: 10.1016/ j.amjsurg.2014.09.006.

14. Nielsen KT, Lund L, Larsen LP et al.Duration of postoperative pneumo­peritoneum. Eur J Surg 1997; 163(7): 501 –⁠ 503.

Labels
Surgery Orthopaedics Trauma surgery
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#