Secondary peritonitis chest x ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]

Overview

An upright and supine plain films of the chest and abdomen should be performed in patients with abdominal pain to exclude free air under the diaphragm (most often on the right), which signals a bowel perforation and associated peritonitis.

Key Chest X-Ray Findings in Secondary peritonitis

  • Free air is present in most cases of anterior gastro-duodenal perforation, but is less frequent with perforations of the small bowel and colon and is unusual with appendiceal perforation.
  • The presence of free air is not mandatory with visceral perforation.
  • Plain chest X-Ray should be considered when gastrointestinal perforation or diseases of the chest such as pneumonia, pericarditis, or myocardial infarction are suspected.
  • The diagnosability of plain abdominal radiography is limited and has no value as a part of routine examination. Even in cases without abnormal findings, ultrasonography (US) or computed tomography (CT) should be considered depending on clinical manifestations.
  • However, in settings without access to US or CT, X-ray in supine and erect positions is considered in patients suspected to have bowel obstruction, ileus, gastrointestinal perforation, calculus urinary, emphysematous lesion, or a foreign body.

Chest X-Ray Examples of Secondary peritonitis

References