What percentage of patients have free intraabdominal air on upright radiograph 24 hours after laparoscopic procedure?
- In the nonpostoperative state, the presence of subdiaphragmatic free air on upright chest radiograph is diagnostic of intraabdominal perforation.
- After an open abdominal or laparoscopic procedure, the significance of free intraabdominal air is less clear.
- Nonpathologic subdiaphragmatic air may be seen in 24% to 39% of patients after laparoscopic surgery and in 60% of patients after open surgical procedures.
- The difference relates to the solubility of carbon dioxide used in laparoscopy versus the solubility of trapped room air within the abdominal cavity.
- Carbon dioxide is more soluble in serum than room air and is absorbed 32 times more quickly.
