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AJR Am J Roentgenol. 1995 Jul;165(1):45-7.

Detection of pneumoperitoneum on chest radiographs: comparison of upright lateral and posteroanterior projections.

Author information

1
Department of Diagnostic Radiology, University of Kentucky Medical Center, Lexington 40536-0084, USA.

Abstract

OBJECTIVE:

This study was done to determine whether upright lateral chest radiographs were more sensitive than upright posteroanterior chest radiographs in detecting pneumoperitoneum.

SUBJECTS AND METHODS:

We prospectively evaluated the ability of upright posteroanterior and lateral chest radiographs to show subdiaphragmatic air in 100 consecutive patients with known pneumoperitoneum from a variety of causes. The difference in sensitivity between the two was evaluated by means of McNemar's test.

RESULTS:

The upright lateral chest radiograph showed pneumoperitoneum in 98% of the cases; the upright posteroanterior chest radiograph showed pneumoperitoneum in only 80%. The upright lateral chest radiograph was significantly better at showing pneumoperitoneum than was the upright posteroanterior chest radiograph (p < .01).

CONCLUSION:

The upright lateral chest radiograph is more sensitive than the upright posteroanterior chest radiograph in detecting small amounts of pneumoperitoneum. When there is a strong clinical suspicion of a perforated hollow viscus, it may be of benefit to include an erect lateral chest radiograph as part of the acute abdominal series.

PMID:
7785629
DOI:
10.2214/ajr.165.1.7785629
[Indexed for MEDLINE]

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