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Monday, May 13, 2013

Signs of pneumoperitoneum U should be familiar with!

Diagnosing pneumoperitoneum is a piece of cake when you see the classic sign " Air under the diaphragm".
Air under diaphragm

But this sign is present in an erect x-ray. Suppose your patient is too sick to get an erect x-ray done ( might be incubated), and instead you get a supine film done, then these are the signs you should look out for.



These include signs like:
1. Falciform ligament signOutline of falciform ligament = long vertical line to the right of midline extending from ligamentum teres notch to umbilicus; most common structure outlined
2. Ligamentum teres sign air outlining fissure of ligamentum teres hepatis
3. Morison’s pouch-doge’s cap sign triangular collection of gas in Morison pouch
4. Cupola sign / moustache signgas trapped below central tendon of diaphragm
5. Rigler’s signair on both sides of bowel as intraluminal gas and free air outside 
6. Football sign: large pneumoperitoneum outlining entire abdominal cavity
7. Telltale triangle sign : triangular air pocket between 3 loops of bowel
8. Inverted “V” sign outline of both lateral umbilical ligaments

This article from the ThaiGastro journal " Pneumoperitoneum: Signs on Supine Abdominal Radiograph" provides detailed look of these signs and images.



5 comments:

Md Biplob said...

Yes your are wright and thanks for post a good topic . your post is

top most in related post of Signs of pneumoperitoneum U should be familiar with!

Chinmaya Deepak said...

good post

Anonymous said...

very good post, thank you.

Anonymous said...

Surely you mean inTubated

Gajanan Repal said...

Thanks for post ....great to rmemeber

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