Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Plain Abdominal Radiograph
Abnormal Gas Distribution
Pneumoperitoneum
Definition
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Free intra-abdominal gas – it usually indicates perforation of a viscus (it is often a peptic ulcer – a perforated appendix rarely demonstrates free gas)
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Other causes: bowel obstruction ▸ appendicitis ▸ bowel ischaemia ▸ diverticular disease ▸ post colonoscopy
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Radiological Features
Erect CXR
Gas is seen under the diaphragm (this can detect as little as 1 ml of free gas) ▸ do not confuse this appearance with Chilaiditi's syndrome (where intestine is seen between the liver and diaphragm) or a subphrenic abscess
Left lateral decubitus AXR
Gas is seen between the liver and abdominal wall
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