Shatari T, Clark M A, Keighley M R B
Department of Surgery, Queen Elizabeth Hospital, University of Birmingham, Edgbaston, Birmingham, B15 2TH, UK.
Tech Coloproctol. 2004 Mar;8(1):27-30. doi: 10.1007/s10151-004-0047-7.
Postoperative pneumoperitoneum on a plain chest radiograph is a potentially important medicolegal document of possible complication. However, pneumoperitoneum may be observed without significance after intra-abdominal procedures.
Between April 2001 and March 2002, 204 consecutive open laparotomies for colorectal surgery were studied. Sixty-three patients had 97 chest radiographs taken before the twenty-fifth postoperative day.
Only one patient had subdiaphragmatic air (height >20 mm) on the tenth postoperative day associated with a visceral perforation. Normal subdiaphragmatic pneumoperitoneum was observed on 11 films in 8 patients (13%). Small amounts of air (<15 mm high) were observed in 7 (15%) of 47 radiographs on days 0-5, in 4 (18%) of 25 radiographs on days 6-10, but in no radiograph of 24 after day 10.
Subdiaphragmatic pneumoperitoneum less than 20 mm high is often observed between the sixth and tenth postoperative days, without clinical importance.
胸部X线平片上的术后气腹是可能并发症的一份潜在重要的法医学文件。然而，在腹部手术后也可能观察到无意义的气腹。
在2001年4月至2002年3月期间，对连续204例接受结直肠手术的开腹手术患者进行了研究。63例患者在术后第25天之前拍摄了97张胸部X线片。
仅1例患者在术后第10天出现膈下气体（高度>20 mm），伴有内脏穿孔。8例患者的11张片子上观察到正常膈下气腹（13%）。在术后0至5天的47张片子中有7张（15%）观察到少量气体（高度<15 mm），在术后6至10天的25张片子中有4张（18%）观察到少量气体，但术后10天后的24张片子中均未观察到。
术后第6天至第10天常观察到高度小于20 mm的膈下气腹，无临床意义。
