Right shoulder tip pain and shortness of breath.
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Rim of subdiaphragmatic free gas.
The lungs are clear with normal pulmonary vascularity. No consolidation, collapse or pneumothorax.
Normal cardiomediastinal contour and visualised bony thorax.
This patient was one day post-operative following a laparoscopic procedure and this free gas was attributed to residual insufflation gas from the operation rather than a perforated viscus.
This appearance is commonly encountered following some abdomino-pelvic operations, usually resolving after a week. If the volume of gas increases though, further investigation is warrented.
- Gayer G, Hertz M, Zissin R. Postoperative pneumoperitoneum: prevalence, duration, and possible significance. Seminars in ultrasound, CT and MRI. 2004: 25(3);286-289. doi:10.1053/j.sult.2004.03.009