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Pneumoperitoneum

Pneumoperitoneum
File:Pneumoperitoneum modification.jpg
Frontal chest X-ray. The air bubble below the right hemidiaphragm (on the left of the image) is a pneumoperitoneum.
Classification and external resources
ICD-10 K66.8
ICD-9 568.89, 770.2
DiseasesDB 31511
eMedicine radio/562
NCI Pneumoperitoneum
Patient UK Pneumoperitoneum
MeSH D011027
File:Pneumoperitoneum chest X-ray.jpg
Another pneumoperitoneum on chest X-ray.
File:Pneumoperitoneum lateral decubitus.jpg
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

Differential diagnosis

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

References

  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