Mehmet DEMİRCAN, Harika GÖZÜKARA BAG, Kubilay GÜRÜNLÜOĞLU, Ahmet SİGİRCİ, Aytaç TAŞCİ

When is free air a sign of complication on abdominal plain radiography after laparotomy in pediatric patients?

Aim: Postoperative free air in the abdomen may not be harmful for the patient, it may be innocent, but it may also be an important indicator or marker of an operation-related complication. In this study we aimed to find out retrospectively when post-operative free air in the abdomen disappears in pediatric patients undergone laparotomy.Material and Methods: From January 2009 to April 2018, records of all pediatric patients under 17 years of age undergoing laparotomy were reviewed. The data of 1570 patients who underwent laparotomy were obtained. Among these patients, 101 patients who complained of vomiting on the first postoperative day were identified. On the first postoperative day, 101 patients with vomiting complaints were found to have abdominal plain radiographs (APR). Among these patients, those who were re-operated were identified. Both groups were statistically analyzed in terms of the disappearance time of free air and demographic information in the APR film.Results: The free air in the group of re-laparotomy continued to be seen for a longer time. We found that free air was lost in APR in 28.7% of patients in 1 day, 60.3% in 2 days, 7.9% in 3 days and 2.9% in 4 days.Conclusion: In our study, we found that free air continued to be seen in APR for 2 days after laparotomy in children. We claim that surgical intervention should be considered as a primary consideration if free air is present in the APR after 3rd postoperative day.

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