pneumoperitoneum

• iatrogenic
  • surgery
  • dialysis
• spontaneous
  • peptic perforation
  • bowel obstruction
  • toxic megacolon
• trauma
  • penetrating or blunt injury
• miscellaneous
  • female genital tract (intercourse, douching, insufflation)
  • pneumatosis intestinalis or coli

duration

• typically 4-5 days (up to 4 wks)
• persists longer in adults than kids, and in thin people

x-ray

• upright chest or left lateral decubitus can detect 1 cc
• gas under diaphragm or lateral liver margin
• football sign
• Rigler sign

© 2002, C.E. Kahn, Jr.
2002-04-18