Pneumoperitoneum

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Pneumoperitoneum
Classification and external resources
Pneumoperitoneum modification.jpg
Frontal chest X-ray. The air bubble below the right hemidiaphragm (on the left of the image) is a pneumoperitoneum.
ICD-10 K66.8
ICD-9 568.89, 770.2
DiseasesDB 31511
eMedicine radio/562
MeSH D011027
Another pneumoperitoneum on chest X-ray.
Pneumoperitoneum seen on X-ray with the patient lying on his left side.

Pneumoperitoneum is the presence of air or gas in the abdominal (peritoneal) cavity. It is often seen on X-ray, but small amounts are often missed, and CT is nowadays regarded as a criterion standard in the assessment of a pneumoperitoneum.[1] CT can visualize quantities as small as 5 cm³ of air or gas. The most common cause is a perforated abdominal viscus, generally a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma. A perforated appendix seldom causes a pneumoperitoneum.

In the mid-twentieth century, an "artificial" pneumoperitoneum was sometimes intentionally administered as a treatment for a hiatal hernia. This was achieved by insufflating the abdomen with carbon dioxide. The practice is currently used by surgical teams in order to perform laparoscopic surgery.

Causes[edit]

Differential diagnosis[edit]

Subphrenic abscess, bowel interposed between diaphragm and liver (Chilaiditi syndrome), and linear atelectasis at the base of the lungs can simulate free air under the diaphragm on a chest X-ray.

See also[edit]

References[edit]

  1. ^ Ali Nawaz Khan. "eMedicine.com: Pneumoperitoneum". 
  2. ^ Necrotizing Enterocolitis Bugs, Drugs and Things That Go Bump in the Night
  3. ^ Sexual Activity as Cause for Non-Surgical Pneumoperitoneum