The death of a man in Essex has prompted a warning about the potential risks of a specialist medical procedure.
Glen Edward Robert Jay died on March 8, 2025, after undergoing progressive preoperative pneumoperitoneum (PPP) at Broomfield Hospital, a technique used before complex abdominal surgery.
Following an inquest, the Essex and Thurrock Coroner’s Service issued a Report to Prevent Future Deaths, raising concerns that the procedure could be offered to patients with a history of recurrent adhesive small bowel obstruction.
Mr Jay had a history of adhesive small bowel obstruction and underwent an emergency laparotomy during his admission after doctors identified a bowel obstruction with suspected ischaemia.
He later had a further bowel resection, anastomosis and abdominal-wall closure, but after surgery on February 26 his condition deteriorated due to severe sepsis; he did not regain consciousness and sadly passed away.
PPP involves gradually introducing air into the abdominal cavity to prepare patients for surgery on very large incisional hernias.
NHS England responded to the coroner’s warning by stating it would issue a notice to chief medical officers and medical directors at all trusts providing or considering PPP.
The notice calls for enhanced governance around the procedure, including formal trust approval, a detailed written protocol, and enhanced patient consent.
NHS England also said every patient considered for PPP must be discussed at a multidisciplinary team meeting, with the outcome clearly recorded in their medical records.
The organisation said a history of acute small bowel obstruction should be considered a “relative contraindication” for PPP.
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NHS England said the concerns raised about Mr Jay’s care had been “listened to and reflected upon”, adding that reports to prevent future deaths are considered nationally so lessons can be shared across the health service.
Hospitals have been advised to ensure protocols are in place to stop or reverse PPP if a patient develops severe pain, and to provide immediate surgery if bowel ischaemia or perforation is suspected.
NHS England said PPP is performed at only a small number of specialist centres in England and is reserved for patients with very large incisional hernias where there is no alternative operation.
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