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Case of the Week 314



What's the most likely diagnosis?

  • 53 year old male with abdominal pain

  1. Liver laceration
  2. Pneumothorax
  3. Pneumoperitoneum
  4. Shock
  5. Asplenia

Additional Image - Axial CT of the abdomen

 

Additional Image

 

Axial CT of the Abdomen

 


Answer:

 


3. Pneumoperitoneum

 

 

More (Click Discussion Tab)


Pneumoperitoneum

Gneral Considerations

Causes of free air

  • Disruption of wall of hollow viscus

    • Blunt or penetrating trauma

    • Perforating foreign body

    • Iatrogenic perforation

      • Laparoscopy / laparotomy

        • Absorbed in <7 days depending on initial amount of air introduced and body habitus

      • Leaking surgical anastomosis

      • Endoscopic perforation

      • Diagnostic pneumoperitoneum

More ...


 


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