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KMID : 0376219660030020223
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Chonnam Medical Journal
1966 Volume.3 No. 2 p.223 ~ p.231
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Diagnostic significance of subphrenic pneumperiitoneum in the determination of Fallopian tubal patiency
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Abstract
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As a tubal patencytest, uterotubal insufflation with air of various amount was performed experimentally on 80 cases of fertileas well as infertile woman, and 60 cases of artificial subphrenic pneumoperitoneum were obtained.
Comparisons were made mainly with shoulder pain, which is a subjective complaint elicited by the production of subphrenic pneumoperitoneum to make it clear whether both are correlated well regardless of amount of air insufflated or not.
The following were the results obtained.
1. The minimum amount of air in producing the subphrenic pneumope-ritoneum was 30 cc. in this study. The common site of occurrence was right .(43.4%) and less frequently both (28.3%) and left (28.3%.)
2. Most of the shoulder pain were noted immediately after pertubation, but late pain was occasionally present in some cases. By site of occurrence, initially right shoulder pain was predominantly noted, however this tend to shift over to the opposite site later. The time incidence of shoulder pain and its se verity found to be influenced by the amount of air insufflated, but individual variation was also noted here.
3. Regarding correlation between subphrenic pneumoperitoneum and shoulder pain 5l cases out of 60 subphrenic pneumoperitoneum did complain of shoulder pain, but rest of 9 cases did not so. That most of shoulder pain negative cases found to be belonged to the group of 30 to 50cc. of air insufflation meant the smaller air insufflated, the greater individual variation is aioted. In this study, 100 cc. of air was appeared to be optimum amount in producing the shoulder pain consistently.
4. In this study, manometric pressure and air bubbling sound appeared to be only a presumptive sign of tubal patency.
5. The X-ray sign of sudphrenic pneumoperitoneum found to be not only the most reliable and confirming evidence of tubal patency, but, complementing the symptom of shoulder pain in doubtful cases in the interpretation of tubal insufflation test.
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