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Please visit www.jssmcradiology.com
for more radiology education
 Supine; RUQ/Liver sign 1
 Linear shape
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radiology education
 Supine; RUQ/Liver sign 2
shaped
lateral
corner
border outlining the
medial border of the
liver
4. Positioned inferior to...
 Supine; RUQ/ Liver sign 3
 Uneven density in
Please visit www.jssmcradiology.com for more
radiology education
 Supine
 Bowel wall
(extraluminal = free
peritoneal gas)
of bowel
wall can be seen
(red arrows)
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 Left lateral
decubitus
 Air-fluid level
between
the abdominal
wall and the liver
in the
peritoneum
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 Supine
 Falciform ligament
 connects the anterior
abdominal wall to the
liver
 extends inferiorly
beyond the liver →
...
 massively air-filled
peritoneum
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radiology education
 massive
pneumoperitoneum
→ sufficient air
beneath the
diaphragm
 left & right
hemidiaphragms
contrasted by the
free gas...
 subdiaphragmatic gas
under the left
hemidiaphragm
 subdiaphragmatic
free gas (under black
arrow)
 normal gas within th...
 Air accumulation
beneath the central
tendon of the
diaphragm
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radiology educ...
 The lesser sac
 positioned posterior to
the stomach
 usually a potential
space
Note:
White arrow = Cupola
sign
Please ...
 small triangles of free
gas positioned
between the large
bowel and the flank
Please visit www.jssmcradiology.com for mor...
 arrowed
NOT clearly contained
within normal hollow
abdominal viscus
 NOT aligned in a linear
fashion nor outline
normal...
 Air seen surrounding
the lateral border of
the kidney
(retroperitoneal
organs)
 If the gas is seen to
move in an erect ...
Urachus Sign
Inverted V
Sign
Leaping
Dolphins Sign
Ligamentum
Teres Sign
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radi...
 Air contrasted
urachus
 Vertical line between
bladder and umbilicus
 Outline of medial
umbilical ligament
Please visit...
 Supine
 Free air outlining the
, coursing
inferiorly and laterally
from the umbilicus
 Infants: umbilical
arteries
 A...
 Air under
hemidiaphragm and
diaphragmatic muscle
slips visible
Please visit www.jssmcradiology.com for more
radiology ed...
 Extraluminal air in the
fissure for the
Ligamentum Teres
 Linear density running
along the inferior edge of
the falcifo...
More Signs:
 Coronary Ligament Outlined by Air
 The coronary ligament sited anterior to the liver
 Pneumo-gall bladder
...
Please visit www.jssmcradiology.com
for more radiology education.
You can contribute for the collection
by email to jssmcr...
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Signs in pneumoperitoneum

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Published on

Pneuperitoneum is best discovered on Abdominal Radiograph.
These signs help in easy detection of the condition

Published in: Education
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Signs in pneumoperitoneum

  1. 1. Please visit www.jssmcradiology.com for more radiology education
  2. 2.  Supine; RUQ/Liver sign 1  Linear shape Please visit www.jssmcradiology.com for more radiology education
  3. 3.  Supine; RUQ/Liver sign 2 shaped lateral corner border outlining the medial border of the liver 4. Positioned inferior to the 11thrib 5. Positioned superior to the right kidney Morrison’s pouch = a potential space between the right kidney & the liver Please visit www.jssmcradiology.com for more radiology education
  4. 4.  Supine; RUQ/ Liver sign 3  Uneven density in Please visit www.jssmcradiology.com for more radiology education
  5. 5.  Supine  Bowel wall (extraluminal = free peritoneal gas) of bowel wall can be seen (red arrows) Please visit www.jssmcradiology.com for more radiology education
  6. 6.  Left lateral decubitus  Air-fluid level between the abdominal wall and the liver in the peritoneum Please visit www.jssmcradiology.com for more radiology education
  7. 7.  Supine  Falciform ligament  connects the anterior abdominal wall to the liver  extends inferiorly beyond the liver → becomes round ligament  becomes in a patient with free abdominal gasPlease visit www.jssmcradiology.com for more radiology education
  8. 8.  massively air-filled peritoneum Please visit www.jssmcradiology.com for more radiology education
  9. 9.  massive pneumoperitoneum → sufficient air beneath the diaphragm  left & right hemidiaphragms contrasted by the free gas appear as a Please visit www.jssmcradiology.com for more radiology education
  10. 10.  subdiaphragmatic gas under the left hemidiaphragm  subdiaphragmatic free gas (under black arrow)  normal gas within the fundus of the stomach (under white arrow) Please visit www.jssmcradiology.com for more radiology education
  11. 11.  Air accumulation beneath the central tendon of the diaphragm Please visit www.jssmcradiology.com for more radiology education
  12. 12.  The lesser sac  positioned posterior to the stomach  usually a potential space Note: White arrow = Cupola sign Please visit www.jssmcradiology.com for more radiology education
  13. 13.  small triangles of free gas positioned between the large bowel and the flank Please visit www.jssmcradiology.com for more radiology education
  14. 14.  arrowed NOT clearly contained within normal hollow abdominal viscus  NOT aligned in a linear fashion nor outline normal haustral features Please visit www.jssmcradiology.com for more radiology education
  15. 15.  Air seen surrounding the lateral border of the kidney (retroperitoneal organs)  If the gas is seen to move in an erect and decubitus view, it's in the retroperitoneum Please visit www.jssmcradiology.com for more radiology education
  16. 16. Urachus Sign Inverted V Sign Leaping Dolphins Sign Ligamentum Teres Sign Please visit www.jssmcradiology.com for more radiology education
  17. 17.  Air contrasted urachus  Vertical line between bladder and umbilicus  Outline of medial umbilical ligament Please visit www.jssmcradiology.com for more radiology education
  18. 18.  Supine  Free air outlining the , coursing inferiorly and laterally from the umbilicus  Infants: umbilical arteries  Adults: inferior epigastric vessels http://dx.doi.org/10.1148/radiology.151.1.62306 89 Please visit www.jssmcradiology.com for more radiology education
  19. 19.  Air under hemidiaphragm and diaphragmatic muscle slips visible Please visit www.jssmcradiology.com for more radiology education
  20. 20.  Extraluminal air in the fissure for the Ligamentum Teres  Linear density running along the inferior edge of the falciform ligament Emerg Med J 2011;28:728 doi:10.1136/emj.2010.098699 Please visit www.jssmcradiology.com for more radiology education
  21. 21. More Signs:  Coronary Ligament Outlined by Air  The coronary ligament sited anterior to the liver  Pneumo-gall bladder  Air in the gall bladder fossa outlining the gall bladder Please visit www.jssmcradiology.com for more radiology education
  22. 22. Please visit www.jssmcradiology.com for more radiology education. You can contribute for the collection by email to jssmcrad@gmail.com

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