-
Medical journals
- Career
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/ccrvch2026217Overview
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
Article was published inPerspectives in Surgery
2026 Issue 5-
All articles in this issue
- Pneumoperitoneum
- Zpráva z kongresu – XXIX. PRAŽSKÉ CHIRURGICKÉ DNY
- Ocenění České chirurgické společnosti ČLS JEP
- Publikační soutěž Rozhledů v chirurgii za rok 2025
- Pneumoperitoneum in diseases and traumas of the upper part of the digestive tract – an overview of current knowledge and clinical context
- Pneumoperitoneum of the lower gastrointestinal tract
- Postoperative pneumoperitoneum
- Benigní pneumoperitoneum
- Imaging of pneumoperitoneum
- Rare causes of pneumoperitoneum
- Perspectives in Surgery
- Journal archive
- Current issue
- Online only
- About the journal
Most read in this issue- Imaging of pneumoperitoneum
- Publikační soutěž Rozhledů v chirurgii za rok 2025
- Pneumoperitoneum in diseases and traumas of the upper part of the digestive tract – an overview of current knowledge and clinical context
- Pneumoperitoneum of the lower gastrointestinal tract
Login#ADS_BOTTOM_SCRIPTS#Forgotten passwordEnter the email address that you registered with. We will send you instructions on how to set a new password.
- Career