Perforation - Erect Chest X-ray

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Perforation - Erect Chest X-ray

  • If perforation is suspected then an erect chest X-ray should be performed as well as an abdominal X-ray.
  • This image shows a very large volume of gas under the diaphragm due to bowel perforation.

Pneumoperitoneum - Erect chest X-ray

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Pneumoperitoneum - Erect chest X-ray

  • An erect chest X-ray can show even a very small volume of free abdominal gas.
  • Reference to the clinical setting is required to determine if this is a potentially life-threatening perforation.
  • This patient had undergone laparoscopic surgery earlier in the day. The free gas under the diaphragm is insufflated carbon dioxide, an acceptable post-surgical finding.
  • A careful check should be made for free gas under the diaphragm on every chest X-ray.