Reappraisal of Pneumoperitoneum After Percutaneous Endoscopic Gastrostomy
- Authors
- Park, Won Young; Lee, Tae Hee; Lee, Joon Seong; Hong, Su Jin; Jeon, Seong Ran; Kim, Hyun Gun; Cho, Joo Young; Kim, Jin Oh; Cho, Jun Hyung; Lee, Sang Wook; Cho, Young Kwan
- Issue Date
- Oct-2015
- Publisher
- 대한장연구학회
- Keywords
- Endoscopy, gastrointestinal; Pneumoperitoneum; Gastrostomy
- Citation
- Intestinal research, v.13, no.4, pp 313 - 317
- Pages
- 5
- Journal Title
- Intestinal research
- Volume
- 13
- Number
- 4
- Start Page
- 313
- End Page
- 317
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/10260
- DOI
- 10.5217/ir.2015.13.4.313
- ISSN
- 1598-9100
2288-1956
- Abstract
- Background/Aims: Pneumoperitoneum is recognized as a benign and self-limiting finding after the insertion of a percutaneous endoscopic gastrostomy (PEG) tube, while complicated pneumoperitoneum is rarely reported. The aim of this study was to reappraise pneumoperitoneum following PEG. Methods: We retrospectively reviewed 193 patients who underwent PEG from May 2008 to May 2014. All patients had a follow-up upright chest or simple abdominal radiograph after PEG. Pneumoperitoneum was quantified by measuring the height of the air column under the diaphragm and graded as small (< 2 cm), moderate (2-4 cm), or large (> 4 cm). Clinically significant signs were defined as fever, abdominal tenderness or leukocytosis occurring after PEG insertion. Results: Of the 193 study patients, 9 (4.6%) had a pneumoperitoneum visualized by radiographic imaging, graded as small in 5 patients, moderate in 2 patients and large in 2 patients. Clinically significant signs were observed in 5 (55.5%) patients with fever reported in 4 patients, abdominal tenderness in 4 patients and leukocytosis in 4 patients. The time to resolution of free air was 2-18 days. Two patients (22.2%) with moderate or large pneumoperitoneum after PEG died from either pneumonia or septic shock. Conclusions: The clinical course of pneumoperitoneum after PEG is not always benign and self-limiting. These findings suggest that clinicians should not neglect a moderate or large pneumoperitoneum, particularly in patients who have an altered mental status or received antibiotics, since peritoneal irritation cannot be observed under these circumstances.
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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
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