Pseudopneumoperitoneum describes any low attenuation within the abdominal cavity that masquerades as free intraperitoneal gas or pneumoperitoneum. Correctly identifying pneumoperitoneum is important, but making the diagnosis in error may lead to further unnecessary investigation or even surgery 1.
Causes of pseudopneumoperitoneum include:
basal linear atelectasis
pneumomediastinum (mimicking cupola sign)
diaphragmatic undulation
gas within skin folds
fat within the subdiaphragmatic space or the ligamentum teres
inferior rib margin
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