Continuous diaphragm sign

Case contributed by Dr Ian Bickle

Presentation

Severe abdominal pain. Perforation?

Patient Data

Age: 22
Gender: Male
X-ray

The diaphragm is clearly identified from right to left due to subdiaphragmatic gas.

It also outlines the fundus of the stomach.

Lungs clear.

Case Discussion

Normally the central portion of the diaphragm is not discretely visualised on chest radiographs as it merges with the cardiac silhouette. If the diaphragm can be seen continuously across the midline then this is highly suggestive of free gas within the upper abdomen as beautifully illustrated in this case.

This is termed the continuous diaphragm sign and is one of several plain radiograph appearances in pneumoperitoneum.

 

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Case information

rID: 50385
Case created: 3rd Jan 2017
Last edited: 3rd Jan 2017
Tag: rdgh
Inclusion in quiz mode: Included

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