Possible Causes for Pneumoperitoneum Laparoscopy We collected data to compare using this new method of peritoneal insufflation with using Palmer's point for pneumoperitoneum. [ncbi.nlm.nih.gov] Take the patient out of Trendelenburg position in order to optimize the decompression of the pneumoperitoneum. [web.archive.org] METHODS: We introduced a new point for Veress needle insertion to create pneumoperitoneum during difficult laparoscopic procedures. [ncbi.nlm.nih.gov] Gastric Rupture She was diagnosed with a massive tension pneumoperitoneum, which was decompressed by needle aspiration. [ncbi.nlm.nih.gov] We recently encountered two cases of gastric rupture with tension pneumoperitoneum that occurred after difficult endotracheal intubation. [ncbi.nlm.nih.gov] Inadvertent esophageal intubation during cardiopulmonary resuscitation following aortocoronary bypass grafting resulted in gastric rupture and tension pneumoperitoneum in [ncbi.nlm.nih.gov] Intestinal Perforation An abdominal X-ray demonstrated extensive PI with pneumoperitoneum mimicking hollow organ perforation. [ncbi.nlm.nih.gov] We present two cases of pneumoperitoneum to discuss the non-surgical management of pneumoperitoneum and describe their outcomes. [afrjpaedsurg.org] Occult spontaneous intestinal perforation (SIP), without pneumoperitoneum on abdominal radiograph, typically occurs in neonates > 2 weeks of age and is usually diagnosed by [ncbi.nlm.nih.gov] Colonic Perforation […] than free fluid upper GI perforation tends to present with a relatively large volume of free fluid and less pneumoperitoneum the presence of pneumoperitoneum in the periportal [radiopaedia.org] Abdominal computed tomography scan showed extensive pneumoperitoneum, pneumoretroperitoneum, pneumomediastinum, and leftsided pneumothorax. [ncbi.nlm.nih.gov] Pneumoperitoneum due to insufflation of gas at laparoscopy has identical appearances. [radiologymasterclass.co.uk] Pneumoperitoneum Pneumoperitoneum Frontal chest X-ray. The air bubble below the right hemidiaphragm (on the left of the image) is a pneumoperitoneum. [en.wikipedia.org] Spontaneous pneumoperitoneum[edit] A spontaneous pneumoperitoneum is a rare case that is not caused by an abdominal organ rupture. [en.wikipedia.org] Pneumoperitoneum seen on X-ray with the patient lying on his left side. Double wall sign. This is a secondary sign of pneumoperitoneum. [en.wikipedia.org] Pneumatosis Cystoides Intestinalis Fig 1 CT scan shows diffuse intramural gas with suspected pneumoperitoneum. a Collection of intaluminal gas in PCI appearing like pneumoperitoneum. b Gas lining the bowel [surgicalcasereports.springeropen.com] PCI with pneumoperitoneum induced by α-glucosidase inhibitor is rare, with only 27 cases (excluding the present case) reported in Japan to date. [ncbi.nlm.nih.gov] Spontaneous pneumoperitoneum - roentgenologic sign found in the supine position. Radiology 1941;37:604–7. Chandler JG, Berk RN, Golden GT. Misleading pneumoperitoneum. [ijcasereportsandimages.com] Duodenal Ulcer Perforation A chest film (Panel A) showed bilateral pneumoperitoneum (arrows). An exploratory laparotomy revealed a perforated duodenal ulcer with callous borders (Panel B). [nejm.org] Gas under diaphragm (pneumoperitoneum) was found in 67 (95.71%). [scopemed.org] Creation of pneumoperitoneum. Insertion of port. Diagnostic laparoscopy & locating the perforation. Cleaning the abdomen. [laparoscopyhospital.com] Mediastinal Emphysema We describe a 36 year-old man with SLE, complicated by bilateral pneumothorax, mediastinal emphysema and pneumoperitoneum. [ncbi.nlm.nih.gov] Pneumoperitoneum (or peritoneal emphysema) is air or gas in the abdominal cavity, and is most commonly caused by gastrointestinal perforation, often the result of surgery. [en.wikipedia.org] Massive pneumoperitoneum and pneumoretroperitoneum after gastroscopy; report of a case and review of the literature. Am J Dig Dis. 1956 Dec;1(12):512–520. [ncbi.nlm.nih.gov] Perforated Peptic Ulcer Pneumoperitoneum and peritonitis were documented, but the symptoms were mild. The "board-like abdomen" sign was not noted. [ncbi.nlm.nih.gov] A chest radiograph revealed a large pneumoperitoneum. She underwent emergent laparoscopic omental patch repair of a perforated ulcer on the anterior wall of her stomach. [ncbi.nlm.nih.gov] Delayed recognition of perforated peptic ulcer with pneumoperitoneum, bowel distension, and decreased abdominal wall compliance can make up a vicious circle and lead to ACS [ncbi.nlm.nih.gov] Perforated Viscus Pneumoperitoneum What are the common causes for pneumoperitoneum? [meddean.luc.edu] The most common cause of pneumoperitoneum is from the disruption of the wall of a hollow viscus. [radiopaedia.org] […] free gas in all cases Iatrogenic pneumoperitoneum Small numbers of cases What size collection is clinically relevant? [bestbets.org] Pulmonary Barotrauma Massive pneumoperitoneum developing immediately following initiation of artificial ventilation is an unusual sign of pulmonary barotrauma, and must be distinguished from pneumoperitoneum [ncbi.nlm.nih.gov] Pulmonary barotrauma was defined as the development of pneumothorax, pneumomediastinum, pneumopericardium, or pneumoperitoneum. [ncbi.nlm.nih.gov] There is also pneumoperitoneum. There is right pleural effusion and areas of higher density in the lung parenchyma corresponding to pneumonic foci. [radiopaedia.org] Complication of Peritoneal Dialysis […] the common noninfectious complications of peritoneal dialysis such as hernias, hydrothorax, hemoperitoneum, pancreatitis, ischemic colitis and necrotizing enterocolitis, pneumoperitoneum [ncbi.nlm.nih.gov] The incidence of pneumoperitoneum with PD is common. [sjkdt.org] Carbon dioxide insufflation of the pneumoperitoneum was established through the umbilical port with a Veress needle, and the intraperitoneal pressure was maintained at 15 [e-fjs.org] Pneumothorax After the start of carbon dioxide-induced pneumoperitoneum, the patient's end-tidal carbon dioxide pressure and heart rate suddenly increased. [ncbi.nlm.nih.gov] We present a case of a patient in whom subcutaneous emphysema, pneumoperitoneum, and pneumothorax occurred on postoperative day 1 after robotic-assisted supracervical hysterectomy [ncbi.nlm.nih.gov] Less commonly, air can encircle the heart, (Pneumopericardium), get under the skin, (Subcutaneous Emphysema), leak into the abdomen (Pneumoperitoneum) or surround the kidneys [unitypoint.org] Perforated Diverticulitis Perforated Diverticulum Plain film Pneumoperitoneum secondary to perforation of diverticulum. [stritch.luc.edu] Fig. 8.5 Colonic perforation: evidence of pneumoperitoneum and air bubbles preferentially located in the pericolic fat ( arrows ) In case of free perforation into the peritoneal [radiologykey.com] […] there is evidence of extraluminal contrast (red arrow) from a perforated diverticulum, Conventional Radiography Sentinel loop or, less likely, LBO Air bubbles in abscess Pneumoperitoneum [learningradiology.com] Esophageal Perforation Despite there are few reports of massive gastric distension causing gastric rupture and pneumoperitoneum after CPR, pneumoperitoneum and esophageal rupture has been rarely [austinpublishinggroup.com] Five patients required additional interventions: four tube thoracostomies for pneumothoraces and one peritoneal drain for pneumoperitoneum. [ncbi.nlm.nih.gov] A CT scan showed a mediastinal abscess, a right pleural effusion associated with a pneumoperitoneum and peritoneal effusion. Then the patient was transferred to us. [ejcts.oxfordjournals.org] Tubo-Ovarian Abscess The chest X-rays revealed the pneumoperitoneum. [ncbi.nlm.nih.gov] A case of tubo-ovarian abscess (TOA) presenting with pneumoperitoneum is unusual. [unboundmedicine.com] PID, STIs 4 2020 Pneumoperitoneum secondary to tubo-ovarian abscess: A case report. [allie.dbcls.jp] Diverticulitis of the Colon […] fistula bowel: coloenteric fistula or colocolic fistula skin: colocutaneous fistula small bowel obstructions from adhesions or bowel wall edema perforation resulting in pneumoperitoneum [radiopaedia.org] […] there is evidence of extraluminal contrast (red arrow) from a perforated diverticulum, Conventional Radiography Sentinel loop or, less likely, LBO Air bubbles in abscess Pneumoperitoneum [learningradiology.com] Plain X-ray of the abdomen showed air under the diaphragm (pneumoperitoneum). The chest X-ray was normal. [saudijgastro.com] Acute Peritonitis […] hemodynamic stability, there are no contraindication to create a pneumoperitoneum when LAPSaroscopic surgery is applicable in cases of peritonitis [wjes.biomedcentral.com] Abdominal X-rays may reveal dilated, edematous intestines, although such X-rays are mainly useful to look for pneumoperitoneum, an indicator of gastrointestinal perforation [en.wikipedia.org] As for peritonitis, there is a theoretical concern that the CO 2 pneumoperitoneum may enhance bacteremia and endotoxemia due to the increased intraperitoneal pressure [ 25 [wjes.biomedcentral.com] Toxic Megacolon […] more likely to have pneumoperitoneum. [wikiradiography.net] There may be signs of pneumoperitoneum if dilatation has progressed to cause perforation. barium studies and colonoscopy should be avoided, due to the risk of perforation [radiopaedia.org] If perforation occurs, radiographic signs of a pneumoperitoneum may be apparent on the supine and/or lateral decubitus radiographs. [13] Clinical examination is not accurate [emedicine.com] Intestinal Infarction Splanchnic mucosal ischaemia: An unrecognized consequence of routine pneumoperitoneum. [journalofmas.com] […] pneumobilia because gas usually reaches the periphery of the liver while pneumobilia is usually about 2 cm short of external liver border, and is more clustered at the hilum pneumoperitoneum [radiopaedia.org] Splanchnic mucosal ischemia. an unrecognized consequence of routine pneumoperitoneum. Surg Laparosc Endosc 1997;7:480–482. CrossRef PubMed Google Scholar 44. [doi.org] Ischemic Bowel Disease […] pneumobilia because gas usually reaches the periphery of the liver while pneumobilia is usually about 2 cm short of external liver border, and is more clustered at the hilum pneumoperitoneum [radiopaedia.org] […] edema, ascites *pitfall : to assume alternate Dx like infectious colitis when you get the non-specific early findings of mesenteric ischemia Late CT Findings: pneumatosis, pneumoperitoneum [emergencymedicinecases.com] 36%) Plain X-rays are often normal or show non-specific findings. [25] In a series of 73 patients, plain abdominal radiography (56%) showing colic distension in 53% or a pneumoperitoneum [en.wikipedia.org] Small Bowel Obstruction […] clinical and/or CT-scan findings predictive for a surgical treatment (free peritoneal fluid, mesenterial edema, transitional point) or a peritonitis (pneumatosis intestinalis, pneumoperitoneum [ncbi.nlm.nih.gov] In other hands, many patients have co-morbidities, and consequently it is key to work with a low intra-abdominal pressure to prevent any conversion for pneumoperitoneum intolerance [websurg.com] […] of bowel ischaemia or perforation included: (1) decreased bowel wall enhancement, (2) pneumatosis intestinalis, (3) portal venous gas, and (4) bowel wall perforation with pneumoperitoneum [journals.plos.org] Tubal Insufflation The CO(2) pneumoperitoneum was released, and the woman stabilized spontaneously. The CO(2) pneumoperitoneum was again established, with no further difficulty. [ncbi.nlm.nih.gov] The duration of CO 2 pneumoperitoneum after laparoscopic surgery has been radiographically shown to resolve within 6 h in most patients, with only minimal amounts of residual [anesthesiology.pubs.asahq.org] With only minor modifications, the Veress needle is still used today to create pneumoperitoneum for laparoscopy. [kiel-school.de] Peptic Ulcer Delayed recognition of perforated peptic ulcer with pneumoperitoneum, bowel distension, and decreased abdominal wall compliance can make up a vicious circle and lead to ACS [ncbi.nlm.nih.gov] Perforation is usually a straightforward diagnosis, often with abundant pneumoperitoneum visible. [radiopaedia.org] The study showed pneumoperitoneum, contrast stasis in heart with decreased caliber of vessels below the abdominal aortic level, and diffuse lymphedema at the abdominal walls [ncbi.nlm.nih.gov] Penetrating Abdominal Trauma TECHNIQUE: After having established pneumoperitoneum and ports placement, the source of bleeding is identified and controlled. [ncbi.nlm.nih.gov] Lymphangioleiomyomatosis Intradermal Injection of Indigo Carmine for Sentinel Node Mapping - 2013 Effects of high positive end-expiratory pressure on haemodynamics and cerebral oxygenation during pneumoperitoneum [medicine.gachon.ac.kr] […] loss Blood in sputum Headache Pain abdomen Complications Ascites Pleural effusion pneumothorax Chylothorax H emoptysis Chyloptysis Chyluria Haematuria Pericardial effusion Pneumoperitoneum [wikidoc.org] […] hemorrhage. [19] Other complications of lymphangioleiomyomatosis (LAM) include the following: Hemoptysis Chylothorax Ascites Chyloptysis Chyluria Hematuria Pericardial effusion Pneumoperitoneum [emedicine.medscape.com] Cardiopulmonary Resuscitation Pneumomediastinum/oesophagus haematoma, n 4 — — Pleural fluid/blood, n 1 3 3 Lung contusion/haematoma, n 1 — 1 Liver rupture, n 1 2 — Intracranial air embolism, n 1 — — Pneumoperitoneum [doi.org] Mechanical Ventilation This can manifest as pneumothorax, pneumoperitoneum, subcutaneous emphysema, pneumomediastinum and can sometimes progress to bronchopleural fistula or tension pneumothorax [clinicaladvisor.com] […] of increase in airway resistance (bronchospasm, obstructed tube) or decrease in compliance of the respiratory system (obesity, atelectasis, selective intubation, surgical pneumoperitoneum [ccforum.biomedcentral.com] Ulcerative Colitis 36%) Plain X-rays are often normal or show non-specific findings. [25] In a series of 73 patients, plain abdominal radiography (56%) showing colic distension in 53% or a pneumoperitoneum [en.wikipedia.org] Pulmonary Lymphangioleiomyomatosis Other less frequent symptoms are hemoptysis, chylous pleural effusions, chylous ascites, pericardial effusion, pneumoperitoneum, acute abdomen, and lymphedema. [scielo.br]
