Pneumoperitoneum on Supine Abdominal X‐Ray: Case Report and Review of the Radiological Signs

Hs, Chiu; Chung, CH

doi:10.1177/102490790501200108

Cited by 4 publications

(5 citation statements)

References 13 publications

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“…An area of hyperlucency at the right upper quadrant obliterating the normal opacity of the liver is suggestive of free intraperitoneal air. [ 11 ] The lucency fades off towards the midline, and it is helpful to compare the opacities of the lateral aspect of the right upper quadrant with that of immediate right side of the midline.…”

Section: Lucency Over the Liver Shadow [ Figurementioning

confidence: 99%

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Radiographic signs of gastrointestinal perforation in children: A pictorial review

Awolaran¹

2015

Afr J Paediatr Surg

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Plain abdominal radiographs remain an important aid for clinicians in the diagnosis of gastrointestinal perforation, especially in neonates and very sick children where clinical features of peritonitis may not be as prominent. Suggestive radiographic features are not always very obvious, especially when taken in the supine position and may lead to delayed or missed diagnosis. Through a pictorial review of plain radiographs, this article highlights a number of documented features of gastrointestinal perforation on X-ray in the paediatric setting, which increases the accuracy of diagnosis.

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Section: Lucency Over the Liver Shadow [ Figurementioning

confidence: 99%

“…[ 6 ] Urachus sign: An outline of the median umbilical ligament seen in the midline as a longitudinal linear opacity between the umbilicus and the bladder. [ 11 ] …”

Section: Accentuation Of Peritoneal Ligaments [Figures 7amentioning

confidence: 99%

Radiographic signs of gastrointestinal perforation in children: A pictorial review

Awolaran¹

2015

Afr J Paediatr Surg

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“… 16 The football sign is an oval hyperlucency on a supine radiograph in the shape of an American football, which is seen when there is a large amount of free air. 17 We observed this sign in 42 (37.17%) infants with perforation. The Rigler sign occurred in 35 (30.97%) infants with perforation.…”

Section: Discussionmentioning

confidence: 56%

“…The demographic data of the neonates, including gender, gestational age, birth weight, age at admission, surgical intervention and outcomes, were collected. Abdominal radiographic X-ray data were collected, including air under the diaphragm, lucency over the liver shadow, 15 the Rigler sign, 16 the falciform ligament sign, 17 the football sign 18 and the triangle sign. 19…”

Section: Methodsmentioning

confidence: 99%

Specific imaging features of intestinal perforation on supine abdominal X-ray evaluation in infants with necrotizing enterocolitis

Zhang

Ling

et al. 2021

World Jnl Ped Surgery

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BackgroundNecrotizing enterocolitis (NEC) is associated with high mortality and morbidity in neonates. For infants with NEC, intestinal perforation is the most serious complication, and confirming perforation and performing radical surgical treatment as early as possible may reduce mortality and sequelae. The aim of this study was to identify the specific imaging characteristics of intestinal perforation after NEC on supine abdominal X-ray for the early diagnosis of intestinal perforation.MethodsA retrospective study was conducted at the Children’s Hospital of Chongqing Medical University. Infants admitted to the hospital from 2013 to 2020 with NEC (Bell’s stage ≥Ⅱ) were divided into perforation and non-perforation groups. All infants were examined by abdominal X-ray in the erect and supine positions. The sensitivity and specificity of specific X-ray signs were analyzed.ResultsA total of 598 infants were included, 113 of whom suffered from perforation. On the supine abdominal films, lucency over the liver shadow, the liver falciform ligament sign, the football sign, the Rigler sign, the triangle sign and more than any one of the above signs had sensitivities of 64.60%, 45.13%, 37.17%, 30.97%, 15.93% and 86.73%, respectively. None of these signs were found on erect or supine abdominal films in the non-perforation group. The total of accuracy of prediction was 46.76%, and the specificity of all the signs was 100%.ConclusionSpecific signs on supine abdominal X-ray could be used to confirm perforation in neonates with NEC with 86.73% sensitivity and 100% specificity.

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“…Pneumoperitoneum could be detected by typical radiological findings in the supine abdominal X-ray including right upper quadrant hyperlucency over the liver, Rigler's sign (double wall sign), falciform ligament sign, telltale triangle sign and football sign etc. 27 The football sign as illustrated in our patient represents the presence of a significant amount of intraabdominal free gas. Prompt diagnosis is the key to potentially life-saving decompression.…”

Section: R a P I D E L E V A T I O N O F I A P D U E T O T E N S I O Nmentioning

confidence: 65%

One More ‘T’ for the Mnemonic of the Management of Pulseless Electrical Activity: Tension Pneumoperitoneum

Wong¹,

Wong²,

Wong³

et al. 2009

Hong Kong j. emerg. med.

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The approach in Advanced Cardiac Life Support provided by the American Heart Association and the European Resuscitation Council guidelines for the management of pulseless electrical activity emphasizes on the search of reversible causes. Tension pneumoperitoneum is an uncommon surgical emergency encountered in the accident and emergency department. We report a case of pulseless electrical activity secondary to tension pneumoperitoneum in an elderly woman. Restoration of spontaneous circulation was immediately achieved after needle decompression. The management of tension pneumoperitoneum is discussed.

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Pneumoperitoneum on Supine Abdominal X‐Ray: Case Report and Review of the Radiological Signs

Cited by 4 publications

References 13 publications

Radiographic signs of gastrointestinal perforation in children: A pictorial review

Radiographic signs of gastrointestinal perforation in children: A pictorial review

Specific imaging features of intestinal perforation on supine abdominal X-ray evaluation in infants with necrotizing enterocolitis

One More ‘T’ for the Mnemonic of the Management of Pulseless Electrical Activity: Tension Pneumoperitoneum

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