title: Pneumoperitoneum and its association with ruptured abdominal viscus.
abstract: Pneumoperitoneum is not invariably associated with ruptured or perforated intra-abdominal viscus. To determine the incidence of free air associated with intra-abdominal viscus perforation, the medical records of 77 consecutive patients whose discharge or autopsy diagnosis included pneumoperitoneum or perforated viscus at a community hospital were retrospectively reviewed between June 1980 and October 1985. Abdominal viscus perforation, as determined by contrast studies or at operation, was not invariably associated with free air. Sixty-nine percent (23/33) of gastroduodenal, 30% (3/10) of small-bowel, and 37% (11/30) of large-bowel perforations had free air, as determined by preoperative x-ray film. Four cases with a total of six episodes of pneumoperitoneum were identified where viscus perforation was not documented. Pneumoperitoneum thus remains a reliable sign of viscus perforation; however, lack of this finding does not rule out perforation, and unusual causes must be considered.
authors.affiliation: Department of Surgery, Good Samaritan Hospital, Portland, OR.
authors.forename: T G
authors.initials: TG
authors.lastname: Winek
authors.forename: H S
authors.initials: HS
authors.lastname: Mosely
authors.forename: G
authors.initials: G
authors.lastname: Grout
authors.forename: D
authors.initials: D
authors.lastname: Luallin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D005836:Genitalia, Female / Q000503:physiopathology; D006801:Humans; D007327:Insufflation / Q000009:adverse effects; D007416:Intestinal Perforation / Q000150:complications* / Q000000981:diagnostic imaging; D007421:Intestine, Small / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications* / Q000000981:diagnostic imaging; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D013275:Stomach Rupture / Q000150:complications*