Air under diaphragm x ray

Key points • The hemidiaphragms are domed structures • Each hemidiaphragm should be well defined • The right hemidiaphragm is slightly higher than the left • The liver is located inferior to the right hemidiaphragm • The stomach and spleen are located inferior to the left hemidiaphragm • The hemidiaphragm contours do not demarcate the lowest part of the lungs The diaphragm separates the lungs from the abdominal organs. The abdominal organs are more dense (whiter) than the air-filled lungs (blacker). Each hemidiaphragm should appear as a smooth, domed contour. The right hemidiaphragm is usually a little higher than the left. The liver is located immediately inferior to the right hemidiaphragm. The stomach and spleen are located immediately inferior to the left hemidiaphragm. The stomach is frequently visible as a gas-filled 'bubble' below the left hemidiaphragm. It is important to be aware that the lowest portion of the lungs – which occupy the posterior costophrenic recesses – extend below the level of the contours of the hemidiaphragms. The stomach bubble forms a window through which this part of the lung is visible on the left. Hover on/off image to show/hide findings Tap on/off image to show/hide findings Click image to align with top of page Hemidiaphragms • The right hemidiaphragm is slightly higher than the left • The liver is located inferior to the right hemidiaphragm • The stomach and spleen are located inferior to the left hemidiaphragm • Lung markings are visibl...

Pneumomediastinum is when air is present in the mediastinum, the space between the lungs and surrounding the heart. Air may enter from a leakage in a lung, the esophagus, or airways. Pneumomediastinum is This article describes what pneumomediastinum is, including its symptoms, causes, and risk factors. We also provide information on how doctors diagnose and treat pneumomediastinum and its complications in adults as well as newborns. Finally, we answer some frequently asked questions about the condition. In Other possible • subcutaneous • • • • • changes in the voice • • A doctor who is listening to the chest of someone with pneumomediastinum may hear a crunching noise that is in time with the heartbeat. Medical professionals refer to this as “Hamman’s crunch.” The sound is due to the heart beating against tissues that are full of air. Pneumomediastinum occurs as a result of air leaking from a lung, esophagus, or airway into the mediastinum. This may occur due to the following: • infection or injury to the neck or chest • tearing of the esophagus or windpipe • surgery on the neck, chest, or abdomen • • forceful coughing due to • • repeated bearing down, such as during a bowel movement or childbirth • chest infections and lung diseases, such as • inhaling toxic fumes • excessive • intense exercise • rapid changes in air pressure while diving • inhaling recreational drugs, such as • using a Factors that increase the likelihood of a pneumomediastinum include: • Age: Compared w...

The gastric bubble is a radiolucent rounded area generally nestled under the left hemidiaphragm representing gas in the fundus of the On a lateral radiograph, the gastric bubble is usually located between the abdominal wall and spine. It can be seen on chest or An important differential is In Related pathology • a left-sided • in • • small studies have linked gastric bubble shapes to the presence of • in a • 1. Rajat Chowdhury, Iain Wilson, Christopher Rofe, Graham Lloyd-Jones. Radiology at a Glance. (2010) • 2. William Herring. Learning Radiology. (2015) • 3. William Londeree, Nathanial Copeland, Evan Ewers, and Donald Helman. Does Gastric Bubble Location on Plain X-ray Predict the Presence of Splenomegaly? (2014) Hawaii J Med Public Health. 2014 Sep; 73(9 Suppl 1): 41. • 4. J W Gurney, D L Olson, and B A Schroeder. The gastric bubble: roentgen observations. (1989) Radiographics. 9 (3): 467-85. • 5. Watanabe T, Urita Y, Maeda T, Sasaki Y, Hike K, Sanaka M, Nakajima H, Sugimoto M. Form of gastric air bubble is associated with gastroesophageal reflux symptoms. (2009) Hepato-gastroenterology. 56 (94-95): 1566-70. • imaging techniques • • radiography • AP • PA • • • • • • • • common • nasogastric tubes • • endotracheal tubes • • • • • • • • • • • • • • • • • • • differential diagnoses of airspace opacification • • • • • • • • • • • • • • • • • • • • morphology-based • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •...

Presentation of the case A 51 year old male patient, a poorly controlled diabetic, presented with a second episode of severe pain abdomen and abdominal distention, with lower abdominal tenderness. Plain Xray of the abdomen in erect posture showed gas under the right dome of diaphragm and ultrasound abdomen confirmed gross pneumoperitoneum. On emergency laparotomy, a pancreatic abscess was discovered, which had ruptured through the inferior leaf of the transverse mesocolon. Discussion There are many obscure causes for extra-intestinal and extra abdominal sources for gas under diaphragm which contribute to 10% of the etiology for the same.These are as follows: post laparotomy status, ruptured liver abscess, retroperitoneal air, biliary-enteric fistula, gall stone ileus, incompetent sphincter of Oddi, focal biliary lipomatosis, post scuba diving, post adeno-tonsillectomy, post dental extraction, following arthroscopy of the knee, intra abdominal sepsis by gas forming organisms and pneumatosis coli to name a few. In this case, Klebsiella was responsible for producing gas under the diaphragm. • About ScienceDirect • Remote access • Shopping cart • Advertise • Contact and support • Terms and conditions • Privacy policy We use cookies to help provide and enhance our service and tailor content and ads. By continuing you agree to the use of cookies. Copyright © 2023 Elsevier B.V. or its licensors or contributors. ScienceDirect® is a registered trademark of Elsevier B.V. ScienceDire...

Article: • • • • • Images: • • Pathology The most common cause of pneumoperitoneum is the disruption of the wall of a hollow viscus. In children, the causes are different from the adult population and are considered in the The causes and, hence, the corresponding severity of accompanying illness, are variable: • perforated hollow viscus • • • • • • • malignancy • • mechanical perforation • trauma • colonoscopy • • iatrogenic • • • vaginal "aspiration" 3 • cunnilingus • douching • sudden squatting • postpartum exercises • water-skiing 10 • mechanical ventilation • • Radiographic features Plain radiograph Chest radiograph An erect chest x-ray is probably the most sensitive plain radiograph for the detection of free intraperitoneal gas. If a large volume pneumoperitoneum is present, it may be superimposed over a normally aerated lung with normal lung markings. • • • • Abdominal radiograph Free gas within the peritoneal cavity can be detected on an abdominal radiograph. The signs created by the free intraperitoneal air can be further divided by anatomical compartments in relation to the pneumoperitoneum: • bowel-related signs • ​​ • • peritoneal ligament-related signs • • • • • right upper quadrant signs • • • • • • Ultrasound Maybe useful in the appropriate clinical setting. A Recognized direct features include: • enhancement of the peritoneal stripe ( 7 • either alone or associated with repeating, horizontal long-path reverberation artifacts which extend into the far field •...

Article: • • • • Images: • Radiographic features Plain radiograph Subdiaphragmatic free gas is well appreciated as the gas under the As little as 1 mL of free gas can be detected but the patient may be needed to be kept in upright position for about 10 minutes for the gas to rise. Erect chest x-rays covering the upper abdomen are often considered the best for detecting free subdiaphragmatic gas but an erect abdominal x-ray covering the lung bases will be just as sensitive. When there is a large amount of free subphrenic gas the Differential diagnosis • • • omental fat interposed between the liver and diaphragm • subpulmonary pneumoperitoneum • enlarged • gas-containing • 1. Radiological Differential Diagnosis. Jaypee Brothers Medical Publishers. (2005) ISBN:8180615006. • 2. SCHENCK S. COLLECTION OF AIR IN THE RIGHT SUBDIAPHRAGMATIC SPACE: WITH SPECIAL REFERENCE TO HEPATODIAPHRAGMATIC INTERPOSITION OF THE COLON. Arch Surg. 01;36 (5): 766-777. • 3. R Saa, A Sarriugarte, M Guerra, L Agirre, H Marin, M Prieto, A Colina. Gas Containing Liver Hematoma: An Unusual Complication Of ERCP. The Internet Journal of Surgery. 2010 Volume 27 Number 2.

There is significant thickening of the proximal sigmoid colon which contains numerous diverticula; marked fat stranding in the left iliac fossa adjacent to the sigmoid colon and free fluid in rectovesical pouch. The findings are in keeping with diverticulitis. Multiple locules of free gas are seen in the left iliac fossa, adjacent to the sigmoid colon in keeping with perforation. In addition, there are multiple locules of gas of various sizes below the diaphragm and adjacent to anterior abdominal wall. Gastrostomy/PEG tube is in-situ. The gallbladder contains a calcified calculus in the fundus.