Classic Xray…

February 3, 2014

Abdomen XR, Abdomen/Pelvis, Non-Trauma, XR

This patient presents with a peritoneal abdomen on exam:

Free air 1 Free air 2 

This is a great abdominal series showing free peritoneal air.  This is a sign of gastric, bowel, or colonic perforation and is a surgical emergency. 

The abdominal series has limited utility in the ED due to poor sensitivity and specificity for most intraabdominal pathology.  However, in a patient with a peritoneal abdomen it is a quick and cost-effective means of screening for free air.  This patient was emergently taken to the operating room for exploratory laparotomy. 

Author:  Russell Jones, MD

Image Contributor:  Ali Naqvi, MD

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