Postoperative pneumoperitoneum.

Postoperative pneumoperitoneum is a relatively common finding on imaging examinations after intra-abdominal surgery, and its correct interpretation is of fundamental clinical importance. The key task is to distinguish between clinically insignificant pneumoperitoneum and findings indicating a serious postoperative complication, particularly anastomotic leak or gastrointestinal perforation. The mere presence of free gas in the abdominal cavity is not an indication for surgical intervention; the decisive factors are the clinical situation, dynamics of changes, and correlation with laboratory and imaging findings. The paper summarizes the incidence, natural course, and localization of postoperative pneumoperitoneum, discusses its surgical and non-surgical causes, and evaluates the significance of individual imaging methods, with an emphasis on the high sensitivity of CT examination. Special attention is paid to risk factors and warning signs that increase the likelihood of a complicated course.