45 Pneumoperitoneum – AXR Fig. 45.1A Large pneumoperitoneum. Background Please see Chapter 27 for an account of perforation on an erect CXR. The diagnosis of pneumoperitoneum is more difficult to make on an AXR than a CXR. However, if it is suspected, both an erect CXR and supine AXR should be performed as an erect CXR is only 80% sensitive for perforation and an AXR may provide further information. AXR is, however, only about 50% sensitive for perforation. The AXR may also reveal the cause of the perforation, for example obstruction. Clinical features Please see Chapter 27. Radiological features Fig. 45.1B Rigler’s sign: On a normal AXR, all air is contained within the bowel lumen. Thus it only outlines the luminal surface of the bowel (arrow 1), The luminal surface of the bowel can be seen because of the difference in density between air and bowel wall (see Introductory section, p. 3). When a viscus perforates, there is air within the peritoneal cavity which can now outline the outside of the bowel wall (arrow 2). This is known as Rigler’s sign, where both sides of the bowel wall are seen. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Permanent pacemakers Gastric outlet obstruction Caecal volvulus Small bowel obstruction Pleural effusion Intussusception Stay updated, free articles. Join our Telegram channel Join Tags: On-Call X-Rays Made Easy Aug 20, 2016 | Posted by admin in ULTRASONOGRAPHY | Comments Off on Pneumoperitoneum – AXR Full access? Get Clinical Tree
45 Pneumoperitoneum – AXR Fig. 45.1A Large pneumoperitoneum. Background Please see Chapter 27 for an account of perforation on an erect CXR. The diagnosis of pneumoperitoneum is more difficult to make on an AXR than a CXR. However, if it is suspected, both an erect CXR and supine AXR should be performed as an erect CXR is only 80% sensitive for perforation and an AXR may provide further information. AXR is, however, only about 50% sensitive for perforation. The AXR may also reveal the cause of the perforation, for example obstruction. Clinical features Please see Chapter 27. Radiological features Fig. 45.1B Rigler’s sign: On a normal AXR, all air is contained within the bowel lumen. Thus it only outlines the luminal surface of the bowel (arrow 1), The luminal surface of the bowel can be seen because of the difference in density between air and bowel wall (see Introductory section, p. 3). When a viscus perforates, there is air within the peritoneal cavity which can now outline the outside of the bowel wall (arrow 2). This is known as Rigler’s sign, where both sides of the bowel wall are seen. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Permanent pacemakers Gastric outlet obstruction Caecal volvulus Small bowel obstruction Pleural effusion Intussusception Stay updated, free articles. Join our Telegram channel Join Tags: On-Call X-Rays Made Easy Aug 20, 2016 | Posted by admin in ULTRASONOGRAPHY | Comments Off on Pneumoperitoneum – AXR Full access? Get Clinical Tree
