Free Intra-Abdominal Air without Peritoneal Perforation after TEM: A Report of Two Cases
Transanal endoscopic microsurgery (TEM) is a minimally invasive treatment modality for a variety of rectal lesions. Due to its minimally invasive nature, TEM has emerged as a safe method. Among most threatening complications are hemorrhage and peritoneal perforation. We report on two patients who de...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2012-01-01
|
| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2012/185429 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832562345154445312 |
|---|---|
| author | Rutger J. Franken Daan E. Moes Yair I. Z. Acherman Eric J. Derksen |
| author_facet | Rutger J. Franken Daan E. Moes Yair I. Z. Acherman Eric J. Derksen |
| author_sort | Rutger J. Franken |
| collection | DOAJ |
| description | Transanal endoscopic microsurgery (TEM) is a minimally invasive treatment modality for a variety of rectal lesions. Due to its minimally invasive nature, TEM has emerged as a safe method. Among most threatening complications are hemorrhage and peritoneal perforation. We report on two patients who demonstrated intra-abdominal free air on an erect chest X-ray after TEM procedure without other findings of a pneumoperitoneum. We hypothesize that due to the combination of elevated pressures in the retroperitoneal cavity and decreased integrity of the retroperitoneal barrier, insufflated CO2 gas can diffuse into the intraperitoneal cavity. Conservative treatment should be considered in patients with free intra-abdominal air postoperatively. However, there should be no suspicion of peritoneal entry during the procedure and the patient should be in generally good condition without severe abdominal symptoms. |
| format | Article |
| id | doaj-art-0d2f2b6e21b441118d33575cc4946d31 |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-0d2f2b6e21b441118d33575cc4946d312025-02-03T01:22:51ZengWileyCase Reports in Surgery2090-69002090-69192012-01-01201210.1155/2012/185429185429Free Intra-Abdominal Air without Peritoneal Perforation after TEM: A Report of Two CasesRutger J. Franken0Daan E. Moes1Yair I. Z. Acherman2Eric J. Derksen3Department of Surgery, Slotervaart Hospital, Louwesweg 6, 1066 EC Amsterdam, The NetherlandsDepartment of Surgery, Slotervaart Hospital, Louwesweg 6, 1066 EC Amsterdam, The NetherlandsDepartment of Surgery, Slotervaart Hospital, Louwesweg 6, 1066 EC Amsterdam, The NetherlandsDepartment of Surgery, Slotervaart Hospital, Louwesweg 6, 1066 EC Amsterdam, The NetherlandsTransanal endoscopic microsurgery (TEM) is a minimally invasive treatment modality for a variety of rectal lesions. Due to its minimally invasive nature, TEM has emerged as a safe method. Among most threatening complications are hemorrhage and peritoneal perforation. We report on two patients who demonstrated intra-abdominal free air on an erect chest X-ray after TEM procedure without other findings of a pneumoperitoneum. We hypothesize that due to the combination of elevated pressures in the retroperitoneal cavity and decreased integrity of the retroperitoneal barrier, insufflated CO2 gas can diffuse into the intraperitoneal cavity. Conservative treatment should be considered in patients with free intra-abdominal air postoperatively. However, there should be no suspicion of peritoneal entry during the procedure and the patient should be in generally good condition without severe abdominal symptoms.http://dx.doi.org/10.1155/2012/185429 |
| spellingShingle | Rutger J. Franken Daan E. Moes Yair I. Z. Acherman Eric J. Derksen Free Intra-Abdominal Air without Peritoneal Perforation after TEM: A Report of Two Cases Case Reports in Surgery |
| title | Free Intra-Abdominal Air without Peritoneal Perforation after TEM: A Report of Two Cases |
| title_full | Free Intra-Abdominal Air without Peritoneal Perforation after TEM: A Report of Two Cases |
| title_fullStr | Free Intra-Abdominal Air without Peritoneal Perforation after TEM: A Report of Two Cases |
| title_full_unstemmed | Free Intra-Abdominal Air without Peritoneal Perforation after TEM: A Report of Two Cases |
| title_short | Free Intra-Abdominal Air without Peritoneal Perforation after TEM: A Report of Two Cases |
| title_sort | free intra abdominal air without peritoneal perforation after tem a report of two cases |
| url | http://dx.doi.org/10.1155/2012/185429 |
| work_keys_str_mv | AT rutgerjfranken freeintraabdominalairwithoutperitonealperforationaftertemareportoftwocases AT daanemoes freeintraabdominalairwithoutperitonealperforationaftertemareportoftwocases AT yairizacherman freeintraabdominalairwithoutperitonealperforationaftertemareportoftwocases AT ericjderksen freeintraabdominalairwithoutperitonealperforationaftertemareportoftwocases |