Freie abdominelle Luft
Subdiaphragmatic free gas is one of the ways of detecting presence of free intraperitoneal gas (i.e. pneumoperitoneum). It is the presence of free, extraluminal gas in the anterior subhepatic space.
Radiographic features
Plain radiograph
Subdiaphragmatic free gas is well appreciated as the gas under the diaphragm and air in the lungs outline the diaphragmatic contour well.
As little as 1 mL of free gas can be detected but the patient may be needed to be kept in upright position for about 10 minutes for the gas to rise.
Erect chest x-rays covering the upper abdomen are often considered the best for detecting free subdiaphragmatic gas but an erect abdominal x-ray covering the lung bases will be just as sensitive.
When there is a large amount of free subphrenic gas the continuous diaphragm sign may be present.
Differential diagnosis
- Chilaiditi sign/syndrome
- subdiaphragmatic abscess
- omental fat interposed between the liver and diaphragm
- subpulmonary pneumoperitoneum
- enlarged gastric bubble
- gas-containing liver hematoma
See also
Siehe auch:
- Pneumothorax
- Appendizitis Bildgebung
- Fremdkörper
- pseudopneumoperitoneum
- Divertikulitis
- peritoneal cavity
- Chronisch-entzündliche Darmerkrankungen
- Mesenterialinfarkt
- Rigler-Zeichen
- Magenulkus
- Mediastinalemphysem
- mechanischer Ileus
- tension pneumoperitoneum
- Linksseitenlage
- football sign
- retropneumoperitoneum
- abnormales Gas im Abdomen
- Nekrotisierende Enterokolitis
- cupola sign
- Pneumoperitoneum beim Neugeborenen
und weiter:
- continuous diaphragm sign
- falciform ligament sign
- retroperitoneal gas
- emphysematöse Cholezystitis
- Chilaiditisyndrom
- Magenperforation
- jejunal perforation following blunt abdominal trauma
- traumatic jejunal perforation
- Überblähung nach Endoskopie
- necrotising enterocolitis staging
- pneumatosis intestinalis in an immunocompromised patient
- post-operative pneumoperitoneum
