Dr Lilis,SpRad

Air within the peritoneal cavity Most common cause is a perforated abdominal viscus Causes of a pneumoperitoneum : - Perforated peptic ulcer , necrotizing enterocolitis, toxic megacolon, inflammatory bowel disease - Infection of the peritoneal cavity - Iatrogenic factors : abdominal surgery, abdominal trauma, leaking surgical anastomosis - Bowel obstruction due to a neoplasm - Pneumatosis intestinalis

Signs of a large pneumoperitoneum : - The football sign - The gas-relief sign, the Rigler sign, and the double-wall sign - Triangle sign represents a triangular pocket of air between 2 loops of bowel and the abdominal wall - Free air under the diaphragm

air under the diaphragm

Upright chest radiograph shows a large collection of air under both hemidiaphragms

pneumoperitoneum outlining the spleen and the superior surface of the liver

Pneumoperitoneum shows the falciform ligament (arrow

Pneumoperitoneum. Supine abdominal radiograph shows a falciform ligament (arrow).

Plate atelectasis at the right lung base mimics a small

pneumoperitoneum.

Large bulla at the base of the right lung mimics a large pneumoperitoneum.

Pneumoperitoneum, mimics.
Image shows colonic interposition. Note the haustra.

dilated loops of the small bowel associated with thickened edematous valvulae conniventes

Small-bowel obstruction

Upper GI barium series

distended jejunal loops large laminated gallstone in

the right iliac fossa (arrow).

of a gallstone ileus.

Small-bowel obstruction
dilated loops of small bowel multiple fluid levels in the small bowel double-contrast barium enema cecum suggestive of an intussusception

Hirschsprung disease. Frontal abdominal radiograph showing marked dilatation of the bowel with no gas in the rectum.

Hirschsprung disease. Frontal abdominal

Radiograph showing marked dilatation

of the small bowel with no gas in the rectum.

Hirschsprung disease. Barium enema

Showing reduced caliber of the rectum,

followed by a transition zone to an enlarged-caliber sigmoid

Barium enema showing reduced caliber

of the rectum, followed by a transition zone to

an enlarged-caliber sigmoid

Barium swallow study demonstrating characteristics of achalasia, including the bird's beak deformity and a dilated esophagus

Atrophic gastritis

Gastric ulcer with symmetrical, radiating mucosal folds

Carcinoma of the cardia with involvement of the distal esophagus

Annular carcinoma of the sigmoid colon circumferential mass with mucosal

and the overhanging edges or shouldering

annular carcinomas in the ascending colon and splenic flexure.

Polypoid carcinoma of the upper rectum

Annular carcinoma in the upper rectum

Crohn disease. Aphthous ulcers.

Crohn disease terminal ileum several narrowing and stricturing

granular mucosa Colitis ulcerative

pseudopolyposis of the descending colon.Haustra menghilang

Colitis ulcerative

granular mucosa in the cecum/ ascending colon

Single-contrast barium enema study shows ulcerative colitis.

the stone is seen as a relatively lucent intravenous urogram

echogenic shadowing calculus in the renal collecting system with hydrone

Abdominal radiograph

calcification filling the left collecting system.

This finding is consistent with a staghorn ca

calcifications over the medullary region of the left kidney in a patient with nephrocalcinosis

moderately hydronephrotic collectingsystem to the level of a proximal ureteral stone (arrow)

Normal retrograde urethrogram

Retrograde urethrogram demonstrates a less common

type II urethral disruption. Extravasation of contrast

material

Straddle injury. Retrograde urethrogram shows a type5 urethral injury with extravasation of contrast material from the distal bulbous urethra.

Conventional cystogram

demonstrating
an intraperitoneal bladder rupture.

intraperitoneal bladder rupture.

Thoracic spine trauma. Lateral radiograph of the thoracic spine with compression fracture (arrow)