Pneumoperitoneum (small)

Case contributed by Dr Ian Bickle


Elderly gentleman with abdominal pain. Non-distended abdomen.

Patient Data

Age: 75 years
Gender: Male

Slither of free gas under the right hemidiaphragm.

Lungs clear.

Case Discussion

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.

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