July 15, 2012

Chest X Ray: Air Under Diaphragm

Gas under diaphragm is synonym with pneumoperitoneum which could be due to many reason. Most of it are due to perforated viscus. Apart from that, other condition may also occurs. Therefore, correct history taking and good physical examination may aid in making a diagnosis.

Differential diagnosis for gas under diaphragm includes.

1) Perforated viscus.
a) GI Malignancies
b) Perforated ulceration of GI Tract
c) Typhoid
d) Tuberculosis
e) Ulcerative Colitis
f) Foreign body
g) Inflammation
h) Diverticulum
1) Trauma
j) Intestinal obstruction

2) Subphrenic abscess with gas

3) Intra abdominal abscess with gas forming organism.

4) Transposition of viscera
eg Chilaiditi syndrome (Interposition of the colon and the liver below the right hemidiaphragm.

5) Spontaneus pneumoperitoneum

6) Idiopathic pneumoperitoneum

7) Pneumatosis cystoides intestinalis (gas cyst of the intestine. a very rare entity usually associated with cararrhal enteritis)

8) Transposition of gas from pneumothorax or lung bullae

1 comment:

Ya Allah! Permudahkanlah aku untuk menuntut ilmuMu, memahaminya, mengingati dan menyebarkannya. Berkatilah ilmu itu dan tambahkanlah ia. Amin.