title: Role of upright chest radiography and ultrasonography in demonstrating free air of perforated peptic ulcers.
abstract: OBJECTIVE
  The purpose of this study was to determine the value of upright chest radiography and ultrasonography in demonstrating free air of perforated peptic ulcers. METHOLOGY: Eighty-four patients with perforated peptic ulcers receiving both upright chest radiography and ultrasonography before laparotomy. The sensitivity of each modality in demonstrating free air was correlated.
  
  
  RESULTS
  Among the 84 patients receiving both examinations, free air was demonstrated in only 39 (46%) upright chest radiographs and 46 (55%) ultrasonographs, the direct sign could be demonstrated in 57 (68%) patients by combined radiography and ultrasonography. Besides, the indirect sign of ascites could be demonstrated in 26 (31%) ultrasonographs.
  
  
  CONCLUSIONS
  Ultrasonography is more sensitive than upright chest radiography to demonstrate free air of perforated peptic ulcers, and it should be considered in those patients of suspected perforated peptic ulcers with negative upright chest radiography. Combined methods of upright chest radiography and ultrasonography can increase the overall sensitivity in demonstrating free air.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Changhua Show-Chwan Memorial Hospital, Taiwan 500, ROC.
authors.forename: C H
authors.initials: CH
authors.lastname: Chen
authors.forename: C C
authors.initials: CC
authors.lastname: Yang
authors.forename: Y H
authors.initials: YH
authors.lastname: Yeh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011027:Pneumoperitoneum / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography