Presentation
Severe abdominal pain. Perforation?
Patient Data
Age: 22
Gender: Male
From the case:
Continuous diaphragm sign
Frontal
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 visualized 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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