- Pneumoperitoneum
Infobox_Disease
Name = PAGENAME
Caption = Frontalchest X-ray . The air bubble below the righthemidiaphragm (on the left of the image) is a pneumoperitoneum.
DiseasesDB = 31511
ICD10 = ICD10|K|66|8|k|65
ICD9 = ICD9|568.89, ICD9|770.2
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj = radio
eMedicineTopic = 562
MeshID = D011027Pneumoperitoneum is air or gas in the abdominal (peritoneal) cavity. It is often seen on
X-ray , but small amounts are often missed, andCT is nowadays regarded as a criterion standard in the assessment of a pneumoperitoneum. [cite web | url = http://www.emedicine.com/radio/topic562.htm | title = eMedicine.com: Pneumoperitoneum" | author = Ali Nawaz Khan]CT can visualize quantities as small as 5 cm³ of air or gas. The most common cause is a perforatedabdominal viscus , generally a perforatedpeptic ulcer , although any part of thebowel may perforate from a benign ulcer,tumor orabdominal trauma . A perforated appendix seldom causes a pneumoperitoneum.A pneumoperitoneum is deliberately created by the surgical team in order to perform
laparoscopic surgery . This is achieved by insufflating the abdomen withcarbon dioxide .Causes
*Perforated
peptic ulcer
*Bowel obstruction
*Ruptureddiverticulum
*Penetrating trauma
*Rupturedinflammatory bowel disease (e.g.megacolon )
*Necrotising enterocolitis /Pneumatosis coli [ [http://www.columbia.edu/itc/hs/medical/humandev/2004/Neonate2.pdf Necrotizing Enterocolitis] Bugs, Drugs and Things That Go Bump in the Night]
*Bowel Cancer
*Ischemic bowel
*Steroids
*Afterlaparotomy
*Afterlaparoscopy
*Breakdown of asurgical anastomosis
*Bowel injury afterendoscopy
*Peritoneal dialysis
*Vaginal insufflation (air enters via thefallopian tubes , e.g. water-skiing, oral sex)
*Colonic or peritonealinfection
*From chest (e.g. bronchopleuralfistula )Differential diagnosis
Subphrenic abscess, bowel interposed between diaphragm and liver (
Chilaiditi syndrome ), and linearatelectasis at the base of the lungs can simulate free air under the diaphragm on a chest X-ray.ee also
*
Football sign
*Rigler's sign References
Wikimedia Foundation. 2010.