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Elderly gentleman with abdominal pain. Non-distended abdomen.
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Slither of free gas under the right hemidiaphragm.
The erect chest x-ray can identify relatively small volumes of pneumoperitoneum provided the patient is in the erect position for a sufficient time for it to navigate under the diaphragm.
CT abdomen typically follows this finding with a view to identifying the cause prior to a laparotomy.