Reflux Of Air Research Articles

Pneumatic Ileal Perforation: An Unusual Complication of Colonoscopy

Pneumatic perforation of the bowel is a rare complication of colonoscopy. Pneumatic ileal perforation complicating this procedure has not been reported. We describe a case of pneumatic ileal perforation during colonoscopy in an elderly lady who also had adhesions from previous abdominal surgery. A relative lack of symptomatology, the finding of a clean ileal perforation at surgery, and a benign postoperative period characterized her course. Possible etiological factors are discussed with reference to the literature dealing with intraluminal pressures in the bowel. Pressure much higher than the physiological pressure is likely to be reached during colonoscopy, with reflux of air across the ileocecal sphincter acting as a safety mechanism. Bursting pressures differ for different layers of the bowel and from segment to segment. This report calls attention to certain risk factors which might lead to a remote perforation during colonoscopy.

Palatal reconstruction utilizing retrieved forehead flap.

Ablation of tumors involving the tonsil and retromolar trigone complex often require partial resection of the soft palate. The pharyngeal wall defect is well reconstructed with the forehead flap. We have used the distal portion of the severed inserted forehead flap to reconstruct the soft palate defect successfully in 35 cases. The nasopharyngeal surface is lined with a book-flap from the remaining palate. This provides full palatal reconstruction with nasopharyngeal mucosa lining: thus preventing flap contracture and the unwanted sequelae of nasopharyngeal air and fluid reflux.

Equipment Notes: NURSING CARE OF THE PATIENT WITH A HEIMLICH VALVE

The Heimlich valve has been used for several hundred patients, including patients with open thoracotomies, persistent pneumothorax, recurrent pleural effusions, and chest injuries with hemopneumothorax. It has been proved to be a completely satisfactory substitute for the underwater drainage bottle system. The valve is an inexpensive, disposable item that is now commercially available. The use of the Heimlich valve does make the nursing care of a patient with chest catheter drainage less complex, but it does not relieve the professional nurse of her responsibility to observe the patient carefully and to maintain a patent drainage system that does not permit reflux of air or fluid into the pleural cavity.