What patient complaint may indicate air has entered the peritoneal cavity?

Shoulder pain can indeed be a significant indicator that air has entered the peritoneal cavity, a situation often referred to as pneumoperitoneum. This phenomenon occurs because the diaphragm is innervated by phrenic nerves that also convey sensations from the shoulder area. As a result, irritation or inflammation of the diaphragm, often due to the presence of gas, can refer pain to the shoulder region, typically the left shoulder. This referred pain is a classic sign seen in cases of perforation in the abdominal cavity or complications in procedures like peritoneal dialysis.

Other symptoms related to air in the peritoneal cavity are typically more situationally specific or may indicate other issues, which is why they are less indicative in this context. Understanding this referral pattern and the significance of shoulder pain helps nursing and dialysis personnel recognize serious complications that may warrant immediate medical attention.