Incidence and Duration of Absorption of Pneumoperitoneum Following Abdominal Operation in Shohadye Tajrish Hosoital - 2006

Introduction & Pneumoperitoneum and especially subdiaphragmatic air, is a very important and noteworthy for the diagnosis and treatment of patients with acute abdominal pain. On the other hand, if a recent abdominal operation has been performed, it is acceptable in 60-80% of cases and will be absorbed gradually. In cases who refer with acute abdominal pain, following a recent abdominal operation, it is or great importance to distinguish between postoperative pneumoperitioneum and the new onsets. On had study, we are decided to clarify the differentiating criteria. During a prospective descriptive survey, 172 patients, in whom abdominal operations with different incisions were performed, underwent chest posteroanterior X-ray imaging in several consecutive postoperative days. So, the incidence of post operative pneumoperitoneum, the duration of complete absorbtion and the intervening factors were all studied. After assessing 172 patients, a postoperative pneumoperitoneum was found in 95 cases (55-2%). The most frequent incision, in which a P.O.P was detected, was the midline laparotomy incision (81.81%). In the decreasing order of frequency, the were lower midline incision (71.42%), upper midline (45%), kocher (41.66%) and Mc Burney (35.7%). The difference between these incision groups has been statistically significant (P < 0.05). In patients with BMI ≥ 25, the incidence rate was 31.9%, in patients with normal BMI, it was 58% and in the underweight group (MBI < 18.5), it was 78.7% and the difference between these different categories was obviously significant (P<0.05). The mean height of air column in the right subdiaphragmatic area was 9.07mm on the first postoperative day. The incidence rate of postoperative pneumoperitoneum, depends on the type of incision and patient’s BMI; regardless of the patient’s age, sex, operation type and the duration of operation. The interval between the incidence of P.O.P and complete resorption dependens on the patient’s age, BMI and the Volume of initial P.O.P.