Bowel Injury and Insidious Pneumoperitoneum after Lateral Lumbar Interbody Fusion
Study Design Retrospective review of prospectively collected cases. Purpose To report bowel injury cases and determine the incidence and risk factors of insidious pneumoperitoneum after lateral lumbar interbody fusion (LLIF). Overview of Literature Minimally invasive LLIF is considered a safe surgic...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2022-08-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2021-0132.pdf |
| _version_ | 1798032313241567232 |
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| author | Eui Seung Hwang Kook Jong Kim Choon Sung Lee Mi Young Lee So Jung Yoon Jae Woo Park Jae Hwan Cho Dong-Ho Lee |
| author_facet | Eui Seung Hwang Kook Jong Kim Choon Sung Lee Mi Young Lee So Jung Yoon Jae Woo Park Jae Hwan Cho Dong-Ho Lee |
| author_sort | Eui Seung Hwang |
| collection | DOAJ |
| description | Study Design Retrospective review of prospectively collected cases. Purpose To report bowel injury cases and determine the incidence and risk factors of insidious pneumoperitoneum after lateral lumbar interbody fusion (LLIF). Overview of Literature Minimally invasive LLIF is considered a safe surgical approach with a low risk of complications. Visceral injury after LLIF is rare and, to our knowledge, no studies on pneumoperitoneum after LLIF have been performed. Bowel injury is a catastrophic complication, but the clinical signs may not be apparent. After we encountered two cases of bowel injury after LLIF, we decided to perform computed tomography of the abdomen and pelvis (APCT) after surgery for all patients who underwent LLIF. Methods A total of 90 patients underwent APCT within 48 hours of surgery. Medical records were reviewed to determine each patient’s age, sex, body mass index, medical and surgical histories, characteristics of LLIF procedures, and subjective symptoms and abnormal findings in the physical examination related to acute abdomen after surgery. Various parameters were compared between patients with and without pneumoperitoneum. Results Bowel injuries were identified in the first two patients and five patients (5.5%) were diagnosed with pneumoperitoneum only on APCT. We found that the greater the number of fused segments, the higher the incidence of postoperative bowel injury and/or pneumoperitoneum. The incidence was significantly high when the L2–3 level was included in the LLIF surgery. Conclusions Pneumoperitoneum after LLIF indicates damage to the peritoneum and the presence of bowel injury that may lead to peritonitis. However, it is difficult to distinguish pneumoperitoneum and/or bowel injury from general abdominal pain after surgery because patients may present with a wide range of symptoms. We recommend that APCT be routinely performed after LLIF surgery in order to promptly identify pneumoperitoneum and bowel injury. |
| first_indexed | 2024-04-11T20:10:47Z |
| format | Article |
| id | doaj.art-b8cbe5ae5f8e4d27b2493843692fe865 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-04-11T20:10:47Z |
| publishDate | 2022-08-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-b8cbe5ae5f8e4d27b2493843692fe8652022-12-22T04:05:06ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462022-08-0116448649210.31616/asj.2021.01321379Bowel Injury and Insidious Pneumoperitoneum after Lateral Lumbar Interbody FusionEui Seung Hwang0Kook Jong Kim1Choon Sung Lee2Mi Young Lee3So Jung Yoon4Jae Woo Park5Jae Hwan Cho6Dong-Ho Lee7 College of Arts and Sciences, Emory University, Atlanta, GA, USA Department of Orthopaedic Surgery, Chungbuk National University College of Medicine, Cheongju, Korea Scoliosis Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Scoliosis Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Scoliosis Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Orthopaedic Surgery, Gangneung Asan Hospital, Gangneung, Korea Scoliosis Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Scoliosis Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaStudy Design Retrospective review of prospectively collected cases. Purpose To report bowel injury cases and determine the incidence and risk factors of insidious pneumoperitoneum after lateral lumbar interbody fusion (LLIF). Overview of Literature Minimally invasive LLIF is considered a safe surgical approach with a low risk of complications. Visceral injury after LLIF is rare and, to our knowledge, no studies on pneumoperitoneum after LLIF have been performed. Bowel injury is a catastrophic complication, but the clinical signs may not be apparent. After we encountered two cases of bowel injury after LLIF, we decided to perform computed tomography of the abdomen and pelvis (APCT) after surgery for all patients who underwent LLIF. Methods A total of 90 patients underwent APCT within 48 hours of surgery. Medical records were reviewed to determine each patient’s age, sex, body mass index, medical and surgical histories, characteristics of LLIF procedures, and subjective symptoms and abnormal findings in the physical examination related to acute abdomen after surgery. Various parameters were compared between patients with and without pneumoperitoneum. Results Bowel injuries were identified in the first two patients and five patients (5.5%) were diagnosed with pneumoperitoneum only on APCT. We found that the greater the number of fused segments, the higher the incidence of postoperative bowel injury and/or pneumoperitoneum. The incidence was significantly high when the L2–3 level was included in the LLIF surgery. Conclusions Pneumoperitoneum after LLIF indicates damage to the peritoneum and the presence of bowel injury that may lead to peritonitis. However, it is difficult to distinguish pneumoperitoneum and/or bowel injury from general abdominal pain after surgery because patients may present with a wide range of symptoms. We recommend that APCT be routinely performed after LLIF surgery in order to promptly identify pneumoperitoneum and bowel injury.http://www.asianspinejournal.org/upload/pdf/asj-2021-0132.pdfbowel injurypneumoperitoneumlateral lumbar interbody fusion |
| spellingShingle | Eui Seung Hwang Kook Jong Kim Choon Sung Lee Mi Young Lee So Jung Yoon Jae Woo Park Jae Hwan Cho Dong-Ho Lee Bowel Injury and Insidious Pneumoperitoneum after Lateral Lumbar Interbody Fusion Asian Spine Journal bowel injury pneumoperitoneum lateral lumbar interbody fusion |
| title | Bowel Injury and Insidious Pneumoperitoneum after Lateral Lumbar Interbody Fusion |
| title_full | Bowel Injury and Insidious Pneumoperitoneum after Lateral Lumbar Interbody Fusion |
| title_fullStr | Bowel Injury and Insidious Pneumoperitoneum after Lateral Lumbar Interbody Fusion |
| title_full_unstemmed | Bowel Injury and Insidious Pneumoperitoneum after Lateral Lumbar Interbody Fusion |
| title_short | Bowel Injury and Insidious Pneumoperitoneum after Lateral Lumbar Interbody Fusion |
| title_sort | bowel injury and insidious pneumoperitoneum after lateral lumbar interbody fusion |
| topic | bowel injury pneumoperitoneum lateral lumbar interbody fusion |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2021-0132.pdf |
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