Pneumoperitoneum

Case contributed by Dr Aditya Shetty

Presentation

Diagnosed with appendicitis. Post laparoscopic surgery x-ray was advised.

Patient Data

Age: 20 years
Gender: Male
X-ray

Radiolucent area noted below the diaphragm across the abdomen

This is gas under the diaphragm

Annotated image

Gas under diaphragm indicated by yellow arrows. This is referred to as continuous diaphragm sign.

Case Discussion

This is a case of pneumoperitoneum post laparoscopy, which can be a "normal" (i.e. expected) finding if the volume of gas is appropriate. 

Normally on a chest xray two hemidiaphragms are demonstrated but in cases of a pneumoperitoneum the entire continuity can be seen.

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