Pneumoperitoneum
High Yield Notes
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Flashcards
Pneumoperitoneum
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Questions
USMLE® Step 1 style questions USMLE
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USMLE® Step 2 style questions USMLE
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A 56-year-old man presents to the emergency department to be evaluated for severe diffuse abdominal pain. He has associated nausea and vomiting. Past medical history is notable for four months of aching and burning epigastric pain, which worsens after eating. He has been managing the epigastric pain by taking over-the-counter antacids. At arrival, temperature is 37.9°C (100.2°F), pulse is 120/min, respirations are 22/min, and blood pressure is 120/66 mm Hg. Diffuse abdominal tenderness to palpation is noted on the physical examination. An upright abdominal radiograph is obtained and shown below. Which of the following best explains this patient’s underlying pathology?
Image reproduced from Wikimedia Commons
Image reproduced from Wikimedia Commons
External References
First Aid
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Pneumoperitoneum p. 371
Summary
Pneumoperitoneum is the abnormal presence of air or other gas in the peritoneal cavity. The most common cause is a perforated abdominal viscus, often a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor, or abdominal trauma. The diagnosis of pneumoperitoneum is typically made by physical examination and imaging tests such as X-rays or CT scan. Treatment involves surgery to address the underlying cause, antibiotics, and supportive care.