Natural History of Extraperitoneal Gas After Renal Transplantation

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Abstract
The natural history of extraperitoneal gas present in the operative bed was prospectively evaluated with serial computed tomography in 25 renal transplant patients. While 73% (11/15) of patients studied within the first 4 days after drain removal had residual gas in the operative bed, 90% (9/10) of patients examined after the 5th day had no demonstrable gas in the peritransplant area. Of 12 patients with gas present on the initial scans, follow-up studies documented resolution of the gas in 10 with subsequent benign clinical courses. In the remaining 2 patients, the gas collections increased in volume on serial examinations followed shortly by wound dehiscence. Gas present later than 1 wk following drain removal seemingly should prompt careful scrutiny; an increase in the volume of gas collections on serial studies must be considered pathologic. The incidence and significance of peritransplant fluid collections in these patients are also discussed.