The etiology of pneumoperitoneum in the 21st century.

نویسندگان

  • Ashwini Kumar
  • Mark T Muir
  • Stephen M Cohn
  • Marc A Salhanick
  • Daniel B Lankford
  • Venkata S Katabathina
چکیده

BACKGROUND We sought to determine the origin of free intraperitoneal air in this era of diminishing prevalence of peptic ulcer disease and imaging studies. In addition, we attempted to stratify the origin of free air by the size of the air collection. METHODS We queried our hospital database for "pneumoperitoneum" from 2005 to 2007 and for proven gastrointestinal perforation from 2000 to 2007. Massive amount of free air was defined as any air pocket greater than 10.0 cm. RESULTS Among patients with free air, the predominant causes were perforated viscus (41%) and postoperative (<8 days) residual air (37%). For patients with visceral perforation, only 45% had free air on imaging studies, and for these patients, the predominant cause was peptic ulcer (16%), diverticulitis (16%), trauma (14%), malignancy (14%), bowel ischemia (10%), appendicitis (6%), and endoscopy (4%). The likelihood that free air was identified on an imaging study by lesion was 72% for perforated peptic ulcer, 57% for perforated diverticulitis, but only 8% for perforated appendicitis. The origin of massive free air was equally likely to be gastroduodenal, small bowel, or colonic perforation. CONCLUSION The cause of free air when surgical pathology is the source has substantially changed from previous reports. LEVEL OF EVIDENCE Epidemiologic study, level IV.

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عنوان ژورنال:
  • The journal of trauma and acute care surgery

دوره 73 3  شماره 

صفحات  -

تاریخ انتشار 2012