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Pneumoperitoneum: Prompt Diagnosis is Crucial Part I

February 20, 2009
Written by: , Filed in: Emergency Radiology
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Pneumoperitoneum must be diagnosed promptly when it occurs, which is often abruptly and without warning.

Author: Stephen R. Baker, MD. Special Presentation, for Practical Reviews in Radiology

The diagnosis of pneumoperitoneum is a crucial diagnosis. Prompt recognition by a radiologist can mean the difference between life and death.

Clinical information, while often helpful, can sometimes be misleading.

Thus, the observation of free air must be made by findings present on radiographic images alone.

Often the first study (and many times the only examination available to the radiologist) is a plain film of the abdomen.

Because the stakes are so high, failure to diagnose a pneumoperitoneum may engender poor patient outcome and a possible malpractice suit.

Compared with other allegations of malpractice pertinent to the gastrointestinal tract, settlements and verdicts against the radiologist for missing free air are much more expensive.

Thus, it is crucial to become familiar with the range of plain film signs of free air.

This discussion will be presented in 2 subsequent parts, both concerned with the various manifestation of pneumoperitoneum as detected radiographically.

Summary of Part 1: Pneumoperitoneum must be diagnosed promptly when it occurs, which is often abruptly and without warning.

Emergency Radiology The University of Washington School of Medicine, Harborview Medical Center, Department of Radiology * Features case-based presentations with extensive explanations – 15 hours of video * What, when, and how of imaging in relation to specific topics in emergency medicine * Stresses the interaction and communication required to be an effective part of the emergency medicine team * Provides guidance in diagnosis of polytrauma, commonly missed diagnoses, and when to change existing protocols Click here to read more or order: Emergency Radiology
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