Intra-abdominal complications and sequellae of pneumoperitoneum.

Several reports in the literature concern animal experiments with pneumoperltoneum and none of these describes any significant local pathologic changes attributed to the presence of air in the peritoneal space.’ Trimble, Eaton and Moore,2 in 1939, reported necropsy findings In 20 patients who had received pneumoperitoneum for varying lengths of time prior to death. Less than half showed any mntraperitoneal change, and In those that did, tuberculous enterocolitis or its sequellae were thought responsible. This, of course, was in the pre-streptomycin era. In a later report Trimble et al.3 described the intraabdominal complications encountered in their series of patients. Mitchell, et al.4 report similar low incidence of abdominal complications. Several authors58 have discussed an apparent increase in incidence of appendicitis in patients with pneumoperitoneum, and have remarked on the poor defense reaction exhibited by these patients. Monte and Bradford, Rogers and Garrett’#{176} and others have postulated an Irritant effect of intraperitoneal air as a factor in the closure of the processus vaginalis in inguinal hernias during pneumoperitoneum therapy. Banyai’4 noted no tendency toward formation of lntraabdominal adhesion as noted on resumption of pneumoperitoneum after temporary discontinuation. Corrlgan” on the other hand reported that two out of five such cases had extensive adhesions preventing adequate reinstitution of the pneumoperltoneum.