This is a basic article for medical students and other non-radiologists
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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Reference article
This is a summary article; we do not have a more in-depth reference article.
Summary
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indications (acute)
- concern for pneumoperitoneum, e.g. bowel perforation
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important pathology
- pneumoperitoneum
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benefits
- quick and accessible
- relatively sensitive for free intraperitoneal gas
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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
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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
- patient positioned erect (sitting) for 10 minutes
Similar tests
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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
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CT abdomen
- tiny amounts of free gas can be identified
- often able to help determine the cause of perforation