Plain film signs of pneumoperitoneum

Abstract

Conventional radiography is the primary diagnostic tool for detecting pneumoperitoneum. In the absence of a benign cause of pneumoperitoneum, the identification of free intraperitoneal gas usually indicates the need for emergency surgery in order to repair a perforated bowel. Conventional radiography includes supine and upright conventional abdominal radiography and upright chest radiography. In the emergency setting, in critically ill patients, radiographic examination is performed in the supine decubitus, with anteroposterior and lateral view of the abdomen and anteroposterior view of the thorax. It is crucial that the radiologist become familiar with the signs of pneumoperitoneum that can be discerned on the supine film of the abdomen.