Postoperative pneumoperitoneum after gynecologic and obstetric surgery

BACKGROUND: Intraabdominal free air on plain X-ray after gynecologic or obstetric surgical procedures is common, but its clinical significance has not been yet well established. The aim of this study was to highlight the benign postop-erative pneumoperitoneum with non-reassuring clinical presentation after open gynecologic and obstetric procedures. METHODS: An observational cohort study was carried out in women who have undergone cesarian delivery, total ab-dominal hysterectomy or myomectomy between 2011 and 2016 at Aretaieion University Hospital. RESULTS: Of the 17 cases reported, 12 women underwent cesarian delivery, three total abdominal hysterectomy and two myomectomy under Pfannenstiel incision. Of the 17 women, bilateral subdiaphragmatic translucent areas were recorded in five; four of these women had undergone cesarian delivery and one myomectomy. No correlation existed between patients' weight and length or width of the translucent area (P>0.05). CONCLUSIONS: The purpose of this study was to draw attention to the non-reassuring clinical presentation of benign pneumoperitoneum after gynecologic and obstetric surgery. The medical and nursing staff involved in the postoperative care of patients should be aware of the mechanisms of air leak and this non-typical, non-reassuring clinical presentation of pneumoperitoneum, in order to differentiate from pulmonary embolism and intraabdominal organ injury.