Pneumoperitoneum (chest radiograph)

Case contributed by Dai Roberts
Diagnosis certain

Presentation

Acute onset abdominal pain and guarding. ?perforation

Patient Data

Age: 60 years
Gender: Male

Gas is beneath both hemidiaphragms, more prominent on the right, in keeping with a pneumoperitoneum.  Sternotomy wires. 

Case Discussion

A pneumoperitoneum should be considered a pathological finding unless there is a recent history of abdominal surgery.  Even then, there should not be a large volume of gas, and correlation with examination findings are important.  

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