Erect chest x-ray (summary)

Erect chest x-rays are standard positioning but are also a specific examination performed for the assessment of subdiaphragmatic free gas (pneumoperitoneum).

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  • indications (acute)
    • concern for pneumoperitoneum, e.g. bowel perforation
  • important pathology
    • pneumoperitoneum
  • benefits
    • quick and accessible
    • relatively sensitive for free intraperitoneal gas
  • limitations
    • sick patients may not be able to sit up for long enough (10 minutes)
    • doesn't help with the cause of perforation
    • modest radiation dose
  • procedure
    • patient positioned erect (sitting) for 10 minutes
      • required to allow gas to settle in the subdiaphragmatic space
    • chest x-ray performed in sitting position
  • chest x-ray
    • may be performed in a variety of positions
    • no delay to allow gas to rise to the top of the abdomen if erect
  • CT abdomen
    • tiny amounts of free gas can be identified
    • often able to help determine the cause of perforation
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Article information

rID: 47293
Synonyms or Alternate Spellings:
  • Erect chest radiograph (summary)
  • Erect CXR (summary)

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Cases and figures

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    Subdiaphragmatic free gas
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    Free subdiaphragmatic gas
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