Bowel perforation - subdiaphragmatic free gas

Case contributed by Dr Rahul Kulkarni

Presentation

Acute abdominal pain.

Patient Data

Age: 45 years
Gender: Male

An erect abdominal x-ray reveals crescentic gas under the right diaphragm.

Case Discussion

Subdiaphragmatic free air has a limited diffrential diagnosis including: pneumoperitoneum, chilaiditi syndrome, situs inversus and subdiaphragmatic abscess.

Erect chest x-rays covering the upper abdomen are often considered the best for detecting free subdiaphragmatic gas but an erect abdominal x-ray covering the lung bases will be just as sensitive.

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Case information

rID: 21444
Published: 23rd Jan 2013
Last edited: 6th Nov 2019
Inclusion in quiz mode: Included

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