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| name = Pneumoperitoneum
| image = Pneumoperitoneum modification.jpg
| caption = Frontal [[chest X-ray]]. The air bubble below the right [[hemidiaphragm]] (on the left of the image) is a pneumoperitoneum.
|
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| symptoms =
| complications =
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'''Pneumoperitoneum''' is [[wikt:pneumatosis|pneumatosis]] (abnormal presence of air or other gas) in the [[peritoneal cavity]], a [[potential space]] within the [[abdominal cavity]]. The most common cause is a perforated [[abdominal organ]], generally from a perforated [[peptic ulcer]], although any part of the [[bowel]] may perforate from a benign ulcer, [[tumor]] or [[abdominal trauma]]. A perforated [[appendix (anatomy)|appendix]] seldom causes a pneumoperitoneum.
Spontaneous pneumoperitoneum is a rare case that is not caused by an abdominal organ rupture. This is also called an idiopathic spontaneous pneumoperitoneum when the cause is not known.
In the mid-twentieth century, an "artificial" pneumoperitoneum was sometimes intentionally administered as a treatment for a [[hiatal hernia]]. This was achieved by insufflating the abdomen with [[carbon dioxide]]. The practice is currently used by surgical teams in order to aid in performing [[laparoscopic surgery]].
==Causes==
* Perforated [[duodenal ulcer]] – The most common cause of rupture in the abdomen. Especially of the anterior aspect of the first part of the duodenum.
* Perforated [[peptic ulcer]]<ref>{{cite web |url= https://www.lecturio.com/concepts/peptic-ulcer-disease/| title= Peptic Ulcer Disease
|website=The Lecturio Medical Concept Library |access-date= 10 August 2021}}</ref>
* [[Bowel obstruction]]<ref>{{cite web |url= https://www.lecturio.com/concepts/large-bowel-obstruction/| title= Large Bowel Obstruction|website=The Lecturio Medical Concept Library |access-date= 10 August 2021}}</ref><ref>{{cite web |url= https://www.lecturio.com/concepts/small-bowel-obstruction/| title= Small Bowel Obstruction|website=The Lecturio Medical Concept Library |access-date= 10 August 2021}}</ref>
* Ruptured [[diverticulum]]<ref>{{Cite web|url=https://www.lexico.com/en/definition/diverticulum|archive-url=https://web.archive.org/web/20190717154824/https://www.lexico.com/en/definition/diverticulum|url-status=dead|archive-date=July 17, 2019|title=diverticulum {{!}} Definition of diverticulum in English by Lexico Dictionaries|website=Lexico Dictionaries {{!}} English|access-date=2019-07-17}}</ref>
* [[Penetrating trauma]]<ref>{{cite book| vauthors = Stewart MG |title = Head, Face, and Neck Trauma: Comprehensive Management |chapter = Principles of ballistics and penetrating trauma |editor = Stewart MG |pages = 188–94|date=2005|publisher=Thieme|isbn=3-13-140331-4 | chapter-url = https://books.google.com/books?id=mOJpd-Sy1kgC&q=%22Penetrating+trauma%22&pg=PA195|access-date=2008-06-12}}</ref>
* Ruptured [[inflammatory bowel disease]] (e.g., [[megacolon]])<ref>{{cite web |url= https://www.lecturio.com/concepts/megacolon/| title= Megacolon|website=The Lecturio Medical Concept Library |access-date= 10 August 2021}}</ref>
* [[Necrotising enterocolitis]]/pneumatosis coli<ref>[http://www.columbia.edu/itc/hs/medical/humandev/2004/Neonate2.pdf Necrotizing Enterocolitis] Bugs, Drugs and Things That Go Bump in the Night</ref>
* [[Colorectal cancer|Bowel cancer]]<ref>{{cite web|title=Colon Cancer Treatment (PDQ®)|url=http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient/page1/AllPages|website=NCI|access-date=29 June 2014|date=2014-05-12|url-status=live|archive-url=https://web.archive.org/web/20140705111552/http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient/page1/AllPages|archive-date=July 5, 2014|df=mdy-all}}</ref>
* [[Ischemic colitis|Ischemic bowel]]<ref>{{cite journal | vauthors = Higgins PD, Davis KJ, Laine L | title = Systematic review: the epidemiology of ischaemic colitis | journal = Alimentary Pharmacology & Therapeutics | volume = 19 | issue = 7 | pages = 729–38 | date = April 2004 | pmid = 15043513 | doi = 10.1111/j.1365-2036.2004.01903.x | hdl-access = free | s2cid = 9575677 | hdl = 2027.42/74164 }}</ref><ref>{{cite journal | vauthors = Brandt LJ, Boley SJ | title = AGA technical review on intestinal ischemia. American Gastrointestinal Association | journal = Gastroenterology | volume = 118 | issue = 5 | pages = 954–68 | date = May 2000 | pmid = 10784596 | doi = 10.1016/S0016-5085(00)70183-1 }}</ref><ref>{{cite journal | author = American Gastroenterological Association | title = American Gastroenterological Association Medical Position Statement: guidelines on intestinal ischemia | journal = Gastroenterology | volume = 118 | issue = 5 | pages = 951–3 | date = May 2000 | pmid = 10784595 | doi = 10.1016/S0016-5085(00)70182-X | url = http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=3069&nbr=2295 | archive-url = https://web.archive.org/web/20070927212511/http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=3069&nbr=2295 | archive-date=2007-09-27 | doi-access = free }}</ref>
* [[Steroids]]
* After [[laparotomy]]
* After [[laparoscopy]]
* Breakdown of a [[surgical anastomosis]]
* Bowel injury after [[endoscopy]]
* [[Peritoneal dialysis]] (PD), although the prevalence of pneumoperitoneum is estimated to be less than 4% among people with PD in a more recent study in the [[United Kingdom]].<ref name="ImranBhat2011">{{cite journal | vauthors = Imran M, Bhat R, Anijeet H | title = Pneumoperitoneum in peritoneal dialysis patients; one centre's experience | journal = NDT Plus | volume = 4 | issue = 2 | pages = 120–3 | date = April 2011 | pmid = 25984130 | pmc = 4421564 | doi = 10.1093/ndtplus/sfq208 }}</ref>
* Vaginal insufflation (air enters via the [[fallopian tubes]]; e.g., water-skiing,<ref>{{cite journal | vauthors = Kizer KW | title = Medical hazards of the water skiing douche | journal = Annals of Emergency Medicine | volume = 9 | issue = 5 | pages = 268–9 | date = May 1980 | pmid = 7369581 | doi = 10.1016/s0196-0644(80)80387-8 | quote = Many injuries can result from water skiing accidents, but the water skiing "douche" is unique to this sport. Although generally causing only discomfort, significant trauma can result from the forceful entry of water into the various body orifices. }}</ref> oral sex<ref>{{cite journal | vauthors = Jacobs VR, Mundhenke C, Maass N, Hilpert F, Jonat W | title = Sexual activity as cause for non-surgical pneumoperitoneum | journal = JSLS | volume = 4 | issue = 4 | pages = 297–300 | date = Oct 2000 | pmid = 11051188 | pmc = 3113190 }}</ref><ref>{{cite journal | vauthors = Cawich SO, Johnson PB, Williams E, Naraynsingh V | title = Non-surgical pneumoperitoneum after oro-genital intercourse | journal = International Journal of Surgery Case Reports | volume = 4 | issue = 11 | pages = 1048–51 | date = 25 Sep 2013 | pmid = 24121052 | pmc = 3825970 | doi = 10.1016/j.ijscr.2013.08.022 }}</ref>)
* Colonic or peritoneal [[infection]]
* From chest (e.g., bronchopleural [[fistula]])
* Non-invasive PAP (positive airway pressure) can force air down duodenum as well as down trachea.
==Spontaneous pneumoperitoneum==
A '''spontaneous pneumoperitoneum''' is a rare case that is not caused by an abdominal organ rupture. This is also called an idiopathic spontaneous pneumoperitoneum when the cause is not known.<ref>{{cite journal | vauthors = Pfister J, Riedtmann-Klee HJ | title = [Idiopathic spontaneous pneumoperitoneum. Case discussion based on two cases, assessment procedure and therapy and review of the literature] | journal = Helvetica Chirurgica Acta | volume = 60 | issue = 1–2 | pages = 49–56 | date = September 1993 | pmid = 8226082 }}</ref> Causes of a spontaneous pneumoperitoneum, with no [[peritonitis]] include a [[barotrauma]] due to [[mechanical ventilation]], and a tracheal rupture following an emergency [[Intubate|intubation]]. In the ventilation case, air had passed from the chest into the abdominal cavity through the [[Thoracic diaphragm|diaphragm.]] In the tracheal rupture air had passed along the [[great vessels]].<ref>{{cite journal | vauthors = Gutkin Z, Iellin A, Meged S, Sorkine P, Geller E | title = Spontaneous pneumoperitoneum without peritonitis | journal = International Surgery | volume = 77 | issue = 3 | pages = 219–23 | date = July 1992 | pmid = 1399374 }}</ref>
==Diagnosis==
{{anchor|signs}}
When present, pneumoperitoneum can often be seen on [[projectional radiography]], but small amounts are often missed, and [[CT scan]] is nowadays regarded as a criterion standard in the assessment of a pneumoperitoneum.<ref>{{cite journal | url = http://www.emedicine.com/radio/topic562.htm | title = Pneumoperitoneum Imaging | vauthors = Khan AN, Chandramohan M | veditors = Coombs BD, Gay SD | journal = Emedicine, Medscape | publisher = WebMD LLC | date = 2017-12-06 }}</ref> CT can visualize quantities as small as 5 cm<sup>3</sup> of air or gas.
Signs that can be seen on projectional radiography are shown below:
The ''double wall sign'' marks the presence of air on both sides of the [[intestine]].<ref>{{cite journal | vauthors = Harkin DW, Blake G | title = Small bowel obstruction in a young adult | journal = Postgraduate Medical Journal | volume = 75 | issue = 881 | pages = 173–5 | date = March 1999 | pmid = 10448501 | pmc = 1741173 | doi = 10.1136/pgmj.75.881.173 }}</ref> However, a false double wall sign can result from two loops of bowel being in contact with one another.<ref>{{cite journal | vauthors = de Lacey G, Bloomberg T, Wignall BK | title = Pneumoperitoneum: the misleading double wall sign | journal = Clinical Radiology | volume = 28 | issue = 4 | pages = 445–8 | date = July 1977 | pmid = 872511 | doi = 10.1016/s0009-9260(77)80161-x }}</ref> The sign is named after [[Leo George Rigler]].<ref>{{cite journal | vauthors = Hirsch M, Cortés C | title = El signo de Leo Rigler: doble pared en neumoperitoneo.| trans-title = The sign of Leo Rigler: double pared in neumoperitoneo. | language = Spanish | journal = Revista chilena de radiología | date = 2009 | volume = 15 | issue = 3 | pages = 152–4 | doi = 10.4067/S0717-93082009000300008 | doi-access = free }}</ref> It is not the same as [[Rigler's triad]].
The ''football sign'' is when the abdomen appears as a large oval [[radiodensity|radiolucency]] reminiscent of an [[football (ball)#American and Canadian football|American football]] on a supine projectional radiograph.<ref name="pmid14990817">{{cite journal | vauthors = Rampton JW | title = The football sign | journal = Radiology | volume = 231 | issue = 1 | pages = 81–2 | date = April 2004 | pmid = 14990817 | doi = 10.1148/radiol.2311011290 }}</ref> The football sign is most frequently seen in [[infant]]s with spontaneous or [[iatrogenic]] [[gastric perforation]] causing pneumoperitoneum. It is also seen in bowel obstruction with secondary perforation, as in [[Hirschprung disease]], midgut volvulus, [[meconium ileus]] and [[intestinal atresia]]. Iatrogenic causes like endoscopic perforation may also give football sign.{{citation needed|date=August 2020}}
The ''Cupola sign'' is seen when air is accumulated under the central tendon of the diaphragm.<ref>{{cite journal | vauthors = Sureka B, Bansal K, Arora A | title = Pneumoperitoneum: What to look for in a radiograph? | journal = Journal of Family Medicine and Primary Care | volume = 4 | issue = 3 | pages = 477–8 | date = 2015 | pmid = 26288798 | pmc = 4535122 | doi = 10.4103/2249-4863.161369 | doi-access = free }}</ref>
<gallery mode="packed" widths="360px" heights="220">
Image:Pneumoperitoneum chest X-ray.jpg|Another pneumoperitoneum on chest X-ray.
Image:Pneumoperitoneum lateral decubitus.jpg|Pneumoperitoneum seen on X-ray with the patient lying on his left side.
File:Double wall sign annotated.jpg|Double wall sign. This is a secondary sign of pneumoperitoneum. Patient is supine, and air within the abdomen and lumen of the bowel accentuate both sides of the bowel wall.
File:UOTW 68 - Ultrasound of the Week 2.webm|Ultrasound finding of pneumoperitoneum known as "peritoneal stripe sign"<ref>{{cite web|title=UOTW #68 - Ultrasound of the Week|url=https://www.ultrasoundoftheweek.com/uotw-68/|website=Ultrasound of the Week|access-date=27 May 2017|date=22 March 2016}}</ref>
</gallery>
===Differential diagnosis===
As differential diagnoses, a [[subphrenic abscess]], bowel interposed between diaphragm and liver ([[Chilaiditi syndrome]]), and linear [[atelectasis]] at the base of the lungs can simulate free air under the diaphragm on a chest X-ray.{{citation needed|date=August 2020}}
==Treatment==
Treatment depends on the cause of the condition.{{citation needed|date=August 2020}}
==Terminology==
Pneumoperitoneum can be described as peritoneal emphysema,<ref name="pmid_25803061">{{cite journal | vauthors = Marian K, Monika K, Bartosz K | title = Spontaneous pneumoperitoneum in a patient after ventilation therapy | journal = Polski Przeglad Chirurgiczny | volume = 86 | issue = 12 | pages = 601–3 | date = March 2015 | pmid = 25803061 | doi = 10.1515/pjs-2015-0008 }}</ref> just as [[pneumomediastinum]] can be called mediastinal emphysema, but ''pneumoperitoneum'' is the usual name.
== See also ==
* [[Cupola sign]]
* [[Football sign]]
* [[Pneumoretroperitoneum]]
* [[Rigler's sign]]
== References ==
{{reflist}}
== External links ==
{{Medical resources
| DiseasesDB = 31511
| ICD10 = {{ICD10|K|66|8|k|65}}
| ICD9 = {{ICD9|568.89}}, {{ICD9|770.2}}
| ICDO =
| OMIM =
| MedlinePlus =
| eMedicineSubj = radio
| eMedicineTopic = 562
| MeshID = D011027
}}
{{Digestive system diseases}}
[[Category:Disorders of fascia]]
[[Category:Peritoneum disorders]]' |
New page wikitext, after the edit (new_wikitext) | '{{Infobox medical condition (new)
| name = Pneumoperitoneum
| image = Pneumoperitoneum modification.jpg
| caption = Frontal [[chest X-ray]]. The air bubble below the right [[hemidiaphragm]] (on the left of the image) is a pneumoperitoneum.
|
| pronounce =
| field =
| synonyms =
| symptoms =
| complications =
| onset =
| duration =
| types =
| causes =
| risks =
| diagnosis =
| differential =
| prevention =
| treatment =
| medication =
| prognosis =
| frequency =
| deaths =
}}
'''Pneumoperitoneum''' is [[wikt:pneumatosis|pneumatosis]] (abnormal presence of air or other gas) in the [[peritoneal cavity]], a [[potential space]] within the [[abdominal cavity]]. The most common cause is a perforated [[abdominal organ]], generally from a perforated [[peptic ulcer]], although any part of the [[bowel]] may perforate from a benign ulcer, [[tumor]] or [[abdominal trauma]]. A perforated [[appendix (anatomy)|appendix]] seldom causes a pneumoperitoneum.
Spontaneous pneumoperitoneum is a rare case that is not caused by an abdominal organ rupture. This is also called an idiopathic spontaneous pneumoperitoneum when the cause is not known.
In the mid-twentieth century, an "artificial" pneumoperitoneum was sometimes intentionally administered as a treatment for a [[hiatal hernia]]. This was achieved by insufflating the abdomen with [[carbon dioxide]]. The practice is currently used by surgical teams in order to aid in performing [[laparoscopic surgery]].
==Causes==
* Perforated [[duodenal ulcer]] – The most common cause of rupture in the abdomen. Especially of the anterior aspect of the first part of the duodenum.
* Perforated [[peptic ulcer]]<ref>{{cite web |url= https://www.lecturio.com/concepts/peptic-ulcer-disease/| title= Peptic Ulcer Disease
|website=The Lecturio Medical Concept Library |access-date= 10 August 2021}}</ref>
* [[Bowel obstruction]]<ref>{{cite web |url= https://www.lecturio.com/concepts/large-bowel-obstruction/| title= Large Bowel Obstruction|website=The Lecturio Medical Concept Library |access-date= 10 August 2021}}</ref><ref>{{cite web |url= https://www.lecturio.com/concepts/small-bowel-obstruction/| title= Small Bowel Obstruction|website=The Lecturio Medical Concept Library |access-date= 10 August 2021}}</ref>
* Ruptured [[diverticulum]]<ref>{{Cite web|url=https://www.lexico.com/en/definition/diverticulum|archive-url=https://web.archive.org/web/20190717154824/https://www.lexico.com/en/definition/diverticulum|url-status=dead|archive-date=July 17, 2019|title=diverticulum {{!}} Definition of diverticulum in English by Lexico Dictionaries|website=Lexico Dictionaries {{!}} English|access-date=2019-07-17}}</ref>
* [[Penetrating trauma]]<ref>{{cite book| vauthors = Stewart MG |title = Head, Face, and Neck Trauma: Comprehensive Management |chapter = Principles of ballistics and penetrating trauma |editor = Stewart MG |pages = 188–94|date=2005|publisher=Thieme|isbn=3-13-140331-4 | chapter-url = https://books.google.com/books?id=mOJpd-Sy1kgC&q=%22Penetrating+trauma%22&pg=PA195|access-date=2008-06-12}}</ref>
* Ruptured [[inflammatory bowel disease]] (e.g., [[megacolon]])<ref>{{cite web |url= https://www.lecturio.com/concepts/megacolon/| title= Megacolon|website=The Lecturio Medical Concept Library |access-date= 10 August 2021}}</ref>
* [[Necrotising enterocolitis]]/pneumatosis coli<ref>[http://www.columbia.edu/itc/hs/medical/humandev/2004/Neonate2.pdf Necrotizing Enterocolitis] Bugs, Drugs and Things That Go Bump in the Night</ref>
* [[Colorectal cancer|Bowel cancer]]<ref>{{cite web|title=Colon Cancer Treatment (PDQ®)|url=http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient/page1/AllPages|website=NCI|access-date=29 June 2014|date=2014-05-12|url-status=live|archive-url=https://web.archive.org/web/20140705111552/http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient/page1/AllPages|archive-date=July 5, 2014|df=mdy-all}}</ref>
* [[Ischemic colitis|Ischemic bowel]]<ref>{{cite journal | vauthors = Higgins PD, Davis KJ, Laine L | title = Systematic review: the epidemiology of ischaemic colitis | journal = Alimentary Pharmacology & Therapeutics | volume = 19 | issue = 7 | pages = 729–38 | date = April 2004 | pmid = 15043513 | doi = 10.1111/j.1365-2036.2004.01903.x | hdl-access = free | s2cid = 9575677 | hdl = 2027.42/74164 }}</ref><ref>{{cite journal | vauthors = Brandt LJ, Boley SJ | title = AGA technical review on intestinal ischemia. American Gastrointestinal Association | journal = Gastroenterology | volume = 118 | issue = 5 | pages = 954–68 | date = May 2000 | pmid = 10784596 | doi = 10.1016/S0016-5085(00)70183-1 }}</ref><ref>{{cite journal | author = American Gastroenterological Association | title = American Gastroenterological Association Medical Position Statement: guidelines on intestinal ischemia | journal = Gastroenterology | volume = 118 | issue = 5 | pages = 951–3 | date = May 2000 | pmid = 10784595 | doi = 10.1016/S0016-5085(00)70182-X | url = http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=3069&nbr=2295 | archive-url = https://web.archive.org/web/20070927212511/http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=3069&nbr=2295 | archive-date=2007-09-27 | doi-access = free }}</ref>
* [[Steroids]]
* After [[laparotomy]]
* After [[laparoscopy]]
* Breakdown of a [[surgical anastomosis]]
* Bowel injury after [[endoscopy]]
* [[Peritoneal dialysis]] (PD), although the prevalence of pneumoperitoneum is estimated to be less than 4% among people with PD in a more recent study in the [[United Kingdom]].<ref name="ImranBhat2011">{{cite journal | vauthors = Imran M, Bhat R, Anijeet H | title = Pneumoperitoneum in peritoneal dialysis patients; one centre's experience | journal = NDT Plus | volume = 4 | issue = 2 | pages = 120–3 | date = April 2011 | pmid = 25984130 | pmc = 4421564 | doi = 10.1093/ndtplus/sfq208 }}</ref>
*your mom
* Vaginal insufflation (air enters via the [[fallopian tubes]]; e.g., water-skiing,<ref>{{cite journal | vauthors = Kizer KW | title = Medical hazards of the water skiing douche | journal = Annals of Emergency Medicine | volume = 9 | issue = 5 | pages = 268–9 | date = May 1980 | pmid = 7369581 | doi = 10.1016/s0196-0644(80)80387-8 | quote = Many injuries can result from water skiing accidents, but the water skiing "douche" is unique to this sport. Although generally causing only discomfort, significant trauma can result from the forceful entry of water into the various body orifices. }}</ref> oral sex<ref>{{cite journal | vauthors = Jacobs VR, Mundhenke C, Maass N, Hilpert F, Jonat W | title = Sexual activity as cause for non-surgical pneumoperitoneum | journal = JSLS | volume = 4 | issue = 4 | pages = 297–300 | date = Oct 2000 | pmid = 11051188 | pmc = 3113190 }}</ref><ref>{{cite journal | vauthors = Cawich SO, Johnson PB, Williams E, Naraynsingh V | title = Non-surgical pneumoperitoneum after oro-genital intercourse | journal = International Journal of Surgery Case Reports | volume = 4 | issue = 11 | pages = 1048–51 | date = 25 Sep 2013 | pmid = 24121052 | pmc = 3825970 | doi = 10.1016/j.ijscr.2013.08.022 }}</ref>)
* Colonic or peritoneal [[infection]]
* From chest (e.g., bronchopleural [[fistula]])
* Non-invasive PAP (positive airway pressure) can force air down duodenum as well as down trachea.
==Spontaneous pneumoperitoneum==
A '''spontaneous pneumoperitoneum''' is a rare case that is not caused by an abdominal organ rupture. This is also called an idiopathic spontaneous pneumoperitoneum when the cause is not known.<ref>{{cite journal | vauthors = Pfister J, Riedtmann-Klee HJ | title = [Idiopathic spontaneous pneumoperitoneum. Case discussion based on two cases, assessment procedure and therapy and review of the literature] | journal = Helvetica Chirurgica Acta | volume = 60 | issue = 1–2 | pages = 49–56 | date = September 1993 | pmid = 8226082 }}</ref> Causes of a spontaneous pneumoperitoneum, with no [[peritonitis]] include a [[barotrauma]] due to [[mechanical ventilation]], and a tracheal rupture following an emergency [[Intubate|intubation]]. In the ventilation case, air had passed from the chest into the abdominal cavity through the [[Thoracic diaphragm|diaphragm.]] In the tracheal rupture air had passed along the [[great vessels]].<ref>{{cite journal | vauthors = Gutkin Z, Iellin A, Meged S, Sorkine P, Geller E | title = Spontaneous pneumoperitoneum without peritonitis | journal = International Surgery | volume = 77 | issue = 3 | pages = 219–23 | date = July 1992 | pmid = 1399374 }}</ref>
==Diagnosis==
{{anchor|signs}}
When present, pneumoperitoneum can often be seen on [[projectional radiography]], but small amounts are often missed, and [[CT scan]] is nowadays regarded as a criterion standard in the assessment of a pneumoperitoneum.<ref>{{cite journal | url = http://www.emedicine.com/radio/topic562.htm | title = Pneumoperitoneum Imaging | vauthors = Khan AN, Chandramohan M | veditors = Coombs BD, Gay SD | journal = Emedicine, Medscape | publisher = WebMD LLC | date = 2017-12-06 }}</ref> CT can visualize quantities as small as 5 cm<sup>3</sup> of air or gas.
Signs that can be seen on projectional radiography are shown below:
The ''double wall sign'' marks the presence of air on both sides of the [[intestine]].<ref>{{cite journal | vauthors = Harkin DW, Blake G | title = Small bowel obstruction in a young adult | journal = Postgraduate Medical Journal | volume = 75 | issue = 881 | pages = 173–5 | date = March 1999 | pmid = 10448501 | pmc = 1741173 | doi = 10.1136/pgmj.75.881.173 }}</ref> However, a false double wall sign can result from two loops of bowel being in contact with one another.<ref>{{cite journal | vauthors = de Lacey G, Bloomberg T, Wignall BK | title = Pneumoperitoneum: the misleading double wall sign | journal = Clinical Radiology | volume = 28 | issue = 4 | pages = 445–8 | date = July 1977 | pmid = 872511 | doi = 10.1016/s0009-9260(77)80161-x }}</ref> The sign is named after [[Leo George Rigler]].<ref>{{cite journal | vauthors = Hirsch M, Cortés C | title = El signo de Leo Rigler: doble pared en neumoperitoneo.| trans-title = The sign of Leo Rigler: double pared in neumoperitoneo. | language = Spanish | journal = Revista chilena de radiología | date = 2009 | volume = 15 | issue = 3 | pages = 152–4 | doi = 10.4067/S0717-93082009000300008 | doi-access = free }}</ref> It is not the same as [[Rigler's triad]].
The ''football sign'' is when the abdomen appears as a large oval [[radiodensity|radiolucency]] reminiscent of an [[football (ball)#American and Canadian football|American football]] on a supine projectional radiograph.<ref name="pmid14990817">{{cite journal | vauthors = Rampton JW | title = The football sign | journal = Radiology | volume = 231 | issue = 1 | pages = 81–2 | date = April 2004 | pmid = 14990817 | doi = 10.1148/radiol.2311011290 }}</ref> The football sign is most frequently seen in [[infant]]s with spontaneous or [[iatrogenic]] [[gastric perforation]] causing pneumoperitoneum. It is also seen in bowel obstruction with secondary perforation, as in [[Hirschprung disease]], midgut volvulus, [[meconium ileus]] and [[intestinal atresia]]. Iatrogenic causes like endoscopic perforation may also give football sign.{{citation needed|date=August 2020}}
The ''Cupola sign'' is seen when air is accumulated under the central tendon of the diaphragm.<ref>{{cite journal | vauthors = Sureka B, Bansal K, Arora A | title = Pneumoperitoneum: What to look for in a radiograph? | journal = Journal of Family Medicine and Primary Care | volume = 4 | issue = 3 | pages = 477–8 | date = 2015 | pmid = 26288798 | pmc = 4535122 | doi = 10.4103/2249-4863.161369 | doi-access = free }}</ref>
<gallery mode="packed" widths="360px" heights="220">
Image:Pneumoperitoneum chest X-ray.jpg|Another pneumoperitoneum on chest X-ray.
Image:Pneumoperitoneum lateral decubitus.jpg|Pneumoperitoneum seen on X-ray with the patient lying on his left side.
File:Double wall sign annotated.jpg|Double wall sign. This is a secondary sign of pneumoperitoneum. Patient is supine, and air within the abdomen and lumen of the bowel accentuate both sides of the bowel wall.
File:UOTW 68 - Ultrasound of the Week 2.webm|Ultrasound finding of pneumoperitoneum known as "peritoneal stripe sign"<ref>{{cite web|title=UOTW #68 - Ultrasound of the Week|url=https://www.ultrasoundoftheweek.com/uotw-68/|website=Ultrasound of the Week|access-date=27 May 2017|date=22 March 2016}}</ref>
</gallery>
===Differential diagnosis===
As differential diagnoses, a [[subphrenic abscess]], bowel interposed between diaphragm and liver ([[Chilaiditi syndrome]]), and linear [[atelectasis]] at the base of the lungs can simulate free air under the diaphragm on a chest X-ray.{{citation needed|date=August 2020}}
==Treatment==
Treatment depends on the cause of the condition.{{citation needed|date=August 2020}}
==Terminology==
Pneumoperitoneum can be described as peritoneal emphysema,<ref name="pmid_25803061">{{cite journal | vauthors = Marian K, Monika K, Bartosz K | title = Spontaneous pneumoperitoneum in a patient after ventilation therapy | journal = Polski Przeglad Chirurgiczny | volume = 86 | issue = 12 | pages = 601–3 | date = March 2015 | pmid = 25803061 | doi = 10.1515/pjs-2015-0008 }}</ref> just as [[pneumomediastinum]] can be called mediastinal emphysema, but ''pneumoperitoneum'' is the usual name.
== See also ==
* [[Cupola sign]]
* [[Football sign]]
* [[Pneumoretroperitoneum]]
* [[Rigler's sign]]
== References ==
{{reflist}}
== External links ==
{{Medical resources
| DiseasesDB = 31511
| ICD10 = {{ICD10|K|66|8|k|65}}
| ICD9 = {{ICD9|568.89}}, {{ICD9|770.2}}
| ICDO =
| OMIM =
| MedlinePlus =
| eMedicineSubj = radio
| eMedicineTopic = 562
| MeshID = D011027
}}
{{Digestive system diseases}}
[[Category:Disorders of fascia]]
[[Category:Peritoneum disorders]]' |
Unified diff of changes made by edit (edit_diff) | '@@ -46,4 +46,5 @@
* Bowel injury after [[endoscopy]]
* [[Peritoneal dialysis]] (PD), although the prevalence of pneumoperitoneum is estimated to be less than 4% among people with PD in a more recent study in the [[United Kingdom]].<ref name="ImranBhat2011">{{cite journal | vauthors = Imran M, Bhat R, Anijeet H | title = Pneumoperitoneum in peritoneal dialysis patients; one centre's experience | journal = NDT Plus | volume = 4 | issue = 2 | pages = 120–3 | date = April 2011 | pmid = 25984130 | pmc = 4421564 | doi = 10.1093/ndtplus/sfq208 }}</ref>
+*your mom
* Vaginal insufflation (air enters via the [[fallopian tubes]]; e.g., water-skiing,<ref>{{cite journal | vauthors = Kizer KW | title = Medical hazards of the water skiing douche | journal = Annals of Emergency Medicine | volume = 9 | issue = 5 | pages = 268–9 | date = May 1980 | pmid = 7369581 | doi = 10.1016/s0196-0644(80)80387-8 | quote = Many injuries can result from water skiing accidents, but the water skiing "douche" is unique to this sport. Although generally causing only discomfort, significant trauma can result from the forceful entry of water into the various body orifices. }}</ref> oral sex<ref>{{cite journal | vauthors = Jacobs VR, Mundhenke C, Maass N, Hilpert F, Jonat W | title = Sexual activity as cause for non-surgical pneumoperitoneum | journal = JSLS | volume = 4 | issue = 4 | pages = 297–300 | date = Oct 2000 | pmid = 11051188 | pmc = 3113190 }}</ref><ref>{{cite journal | vauthors = Cawich SO, Johnson PB, Williams E, Naraynsingh V | title = Non-surgical pneumoperitoneum after oro-genital intercourse | journal = International Journal of Surgery Case Reports | volume = 4 | issue = 11 | pages = 1048–51 | date = 25 Sep 2013 | pmid = 24121052 | pmc = 3825970 | doi = 10.1016/j.ijscr.2013.08.022 }}</ref>)
* Colonic or peritoneal [[infection]]
' |
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Parsed HTML source of the new revision (new_html) | '<div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1218072481">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}body.skin-minerva .mw-parser-output .infobox-header,body.skin-minerva .mw-parser-output .infobox-subheader,body.skin-minerva .mw-parser-output .infobox-above,body.skin-minerva .mw-parser-output .infobox-title,body.skin-minerva .mw-parser-output .infobox-image,body.skin-minerva .mw-parser-output .infobox-full-data,body.skin-minerva .mw-parser-output .infobox-below{text-align:center}html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data div{background:#1f1f23!important;color:#f8f9fa}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data div{background:#1f1f23!important;color:#f8f9fa}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Pneumoperitoneum</th></tr><tr><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Pneumoperitoneum_modification.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3c/Pneumoperitoneum_modification.jpg/220px-Pneumoperitoneum_modification.jpg" decoding="async" width="220" height="243" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3c/Pneumoperitoneum_modification.jpg/330px-Pneumoperitoneum_modification.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3c/Pneumoperitoneum_modification.jpg/440px-Pneumoperitoneum_modification.jpg 2x" data-file-width="843" data-file-height="931" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">Frontal <a href="/wiki/Chest_X-ray" class="mw-redirect" title="Chest X-ray">chest X-ray</a>. The air bubble below the right <a href="/wiki/Hemidiaphragm" class="mw-redirect" title="Hemidiaphragm">hemidiaphragm</a> (on the left of the image) is a pneumoperitoneum.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Gastroenterology" title="Gastroenterology">Gastroenterology</a> <span class="penicon autoconfirmed-show"><span class="mw-valign-text-top" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q163469?uselang=en#P1995" title="Edit this on Wikidata"><img alt="Edit this on Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></td></tr></tbody></table>
<p><b>Pneumoperitoneum</b> is <a href="https://en.wiktionary.org/wiki/pneumatosis" class="extiw" title="wikt:pneumatosis">pneumatosis</a> (abnormal presence of air or other gas) in the <a href="/wiki/Peritoneal_cavity" title="Peritoneal cavity">peritoneal cavity</a>, a <a href="/wiki/Potential_space" title="Potential space">potential space</a> within the <a href="/wiki/Abdominal_cavity" title="Abdominal cavity">abdominal cavity</a>. The most common cause is a perforated <a href="/wiki/Abdominal_organ" class="mw-redirect" title="Abdominal organ">abdominal organ</a>, generally from a perforated <a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">peptic ulcer</a>, although any part of the <a href="/wiki/Bowel" class="mw-redirect" title="Bowel">bowel</a> may perforate from a benign ulcer, <a href="/wiki/Tumor" class="mw-redirect" title="Tumor">tumor</a> or <a href="/wiki/Abdominal_trauma" title="Abdominal trauma">abdominal trauma</a>. A perforated <a href="/wiki/Appendix_(anatomy)" title="Appendix (anatomy)">appendix</a> seldom causes a pneumoperitoneum.
</p><p>Spontaneous pneumoperitoneum is a rare case that is not caused by an abdominal organ rupture. This is also called an idiopathic spontaneous pneumoperitoneum when the cause is not known.
</p><p>In the mid-twentieth century, an "artificial" pneumoperitoneum was sometimes intentionally administered as a treatment for a <a href="/wiki/Hiatal_hernia" title="Hiatal hernia">hiatal hernia</a>. This was achieved by insufflating the abdomen with <a href="/wiki/Carbon_dioxide" title="Carbon dioxide">carbon dioxide</a>. The practice is currently used by surgical teams in order to aid in performing <a href="/wiki/Laparoscopic_surgery" class="mw-redirect" title="Laparoscopic surgery">laparoscopic surgery</a>.
</p>
<div id="toc" class="toc" role="navigation" aria-labelledby="mw-toc-heading"><input type="checkbox" role="button" id="toctogglecheckbox" class="toctogglecheckbox" style="display:none" /><div class="toctitle" lang="en" dir="ltr"><h2 id="mw-toc-heading">Contents</h2><span class="toctogglespan"><label class="toctogglelabel" for="toctogglecheckbox"></label></span></div>
<ul>
<li class="toclevel-1 tocsection-1"><a href="#Causes"><span class="tocnumber">1</span> <span class="toctext">Causes</span></a></li>
<li class="toclevel-1 tocsection-2"><a href="#Spontaneous_pneumoperitoneum"><span class="tocnumber">2</span> <span class="toctext">Spontaneous pneumoperitoneum</span></a></li>
<li class="toclevel-1 tocsection-3"><a href="#Diagnosis"><span class="tocnumber">3</span> <span class="toctext">Diagnosis</span></a>
<ul>
<li class="toclevel-2 tocsection-4"><a href="#Differential_diagnosis"><span class="tocnumber">3.1</span> <span class="toctext">Differential diagnosis</span></a></li>
</ul>
</li>
<li class="toclevel-1 tocsection-5"><a href="#Treatment"><span class="tocnumber">4</span> <span class="toctext">Treatment</span></a></li>
<li class="toclevel-1 tocsection-6"><a href="#Terminology"><span class="tocnumber">5</span> <span class="toctext">Terminology</span></a></li>
<li class="toclevel-1 tocsection-7"><a href="#See_also"><span class="tocnumber">6</span> <span class="toctext">See also</span></a></li>
<li class="toclevel-1 tocsection-8"><a href="#References"><span class="tocnumber">7</span> <span class="toctext">References</span></a></li>
<li class="toclevel-1 tocsection-9"><a href="#External_links"><span class="tocnumber">8</span> <span class="toctext">External links</span></a></li>
</ul>
</div>
<h2><span class="mw-headline" id="Causes">Causes</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pneumoperitoneum&action=edit&section=1" title="Edit section: Causes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<ul><li>Perforated <a href="/wiki/Duodenal_ulcer" class="mw-redirect" title="Duodenal ulcer">duodenal ulcer</a> – The most common cause of rupture in the abdomen. Especially of the anterior aspect of the first part of the duodenum.</li>
<li>Perforated <a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">peptic ulcer</a><sup id="cite_ref-1" class="reference"><a href="#cite_note-1">[1]</a></sup></li>
<li><a href="/wiki/Bowel_obstruction" title="Bowel obstruction">Bowel obstruction</a><sup id="cite_ref-2" class="reference"><a href="#cite_note-2">[2]</a></sup><sup id="cite_ref-3" class="reference"><a href="#cite_note-3">[3]</a></sup></li>
<li>Ruptured <a href="/wiki/Diverticulum" title="Diverticulum">diverticulum</a><sup id="cite_ref-4" class="reference"><a href="#cite_note-4">[4]</a></sup></li>
<li><a href="/wiki/Penetrating_trauma" title="Penetrating trauma">Penetrating trauma</a><sup id="cite_ref-5" class="reference"><a href="#cite_note-5">[5]</a></sup></li>
<li>Ruptured <a href="/wiki/Inflammatory_bowel_disease" title="Inflammatory bowel disease">inflammatory bowel disease</a> (e.g., <a href="/wiki/Megacolon" title="Megacolon">megacolon</a>)<sup id="cite_ref-6" class="reference"><a href="#cite_note-6">[6]</a></sup></li>
<li><a href="/wiki/Necrotising_enterocolitis" class="mw-redirect" title="Necrotising enterocolitis">Necrotising enterocolitis</a>/pneumatosis coli<sup id="cite_ref-7" class="reference"><a href="#cite_note-7">[7]</a></sup></li>
<li><a href="/wiki/Colorectal_cancer" title="Colorectal cancer">Bowel cancer</a><sup id="cite_ref-8" class="reference"><a href="#cite_note-8">[8]</a></sup></li>
<li><a href="/wiki/Ischemic_colitis" title="Ischemic colitis">Ischemic bowel</a><sup id="cite_ref-9" class="reference"><a href="#cite_note-9">[9]</a></sup><sup id="cite_ref-10" class="reference"><a href="#cite_note-10">[10]</a></sup><sup id="cite_ref-11" class="reference"><a href="#cite_note-11">[11]</a></sup></li>
<li><a href="/wiki/Steroids" class="mw-redirect" title="Steroids">Steroids</a></li>
<li>After <a href="/wiki/Laparotomy" title="Laparotomy">laparotomy</a></li>
<li>After <a href="/wiki/Laparoscopy" title="Laparoscopy">laparoscopy</a></li>
<li>Breakdown of a <a href="/wiki/Surgical_anastomosis" title="Surgical anastomosis">surgical anastomosis</a></li>
<li>Bowel injury after <a href="/wiki/Endoscopy" title="Endoscopy">endoscopy</a></li>
<li><a href="/wiki/Peritoneal_dialysis" title="Peritoneal dialysis">Peritoneal dialysis</a> (PD), although the prevalence of pneumoperitoneum is estimated to be less than 4% among people with PD in a more recent study in the <a href="/wiki/United_Kingdom" title="United Kingdom">United Kingdom</a>.<sup id="cite_ref-ImranBhat2011_12-0" class="reference"><a href="#cite_note-ImranBhat2011-12">[12]</a></sup></li>
<li>your mom</li>
<li>Vaginal insufflation (air enters via the <a href="/wiki/Fallopian_tubes" class="mw-redirect" title="Fallopian tubes">fallopian tubes</a>; e.g., water-skiing,<sup id="cite_ref-13" class="reference"><a href="#cite_note-13">[13]</a></sup> oral sex<sup id="cite_ref-14" class="reference"><a href="#cite_note-14">[14]</a></sup><sup id="cite_ref-15" class="reference"><a href="#cite_note-15">[15]</a></sup>)</li>
<li>Colonic or peritoneal <a href="/wiki/Infection" title="Infection">infection</a></li>
<li>From chest (e.g., bronchopleural <a href="/wiki/Fistula" title="Fistula">fistula</a>)</li>
<li>Non-invasive PAP (positive airway pressure) can force air down duodenum as well as down trachea.</li></ul>
<h2><span class="mw-headline" id="Spontaneous_pneumoperitoneum">Spontaneous pneumoperitoneum</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pneumoperitoneum&action=edit&section=2" title="Edit section: Spontaneous pneumoperitoneum"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<p>A <b>spontaneous pneumoperitoneum</b> is a rare case that is not caused by an abdominal organ rupture. This is also called an idiopathic spontaneous pneumoperitoneum when the cause is not known.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16">[16]</a></sup> Causes of a spontaneous pneumoperitoneum, with no <a href="/wiki/Peritonitis" title="Peritonitis">peritonitis</a> include a <a href="/wiki/Barotrauma" title="Barotrauma">barotrauma</a> due to <a href="/wiki/Mechanical_ventilation" title="Mechanical ventilation">mechanical ventilation</a>, and a tracheal rupture following an emergency <a href="/wiki/Intubate" class="mw-redirect" title="Intubate">intubation</a>. In the ventilation case, air had passed from the chest into the abdominal cavity through the <a href="/wiki/Thoracic_diaphragm" title="Thoracic diaphragm">diaphragm.</a> In the tracheal rupture air had passed along the <a href="/wiki/Great_vessels" title="Great vessels">great vessels</a>.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17">[17]</a></sup>
</p>
<h2><span class="mw-headline" id="Diagnosis">Diagnosis</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pneumoperitoneum&action=edit&section=3" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<p><span class="anchor" id="signs"></span>
When present, pneumoperitoneum can often be seen on <a href="/wiki/Projectional_radiography" title="Projectional radiography">projectional radiography</a>, but small amounts are often missed, and <a href="/wiki/CT_scan" title="CT scan">CT scan</a> is nowadays regarded as a criterion standard in the assessment of a pneumoperitoneum.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18">[18]</a></sup> CT can visualize quantities as small as 5 cm<sup>3</sup> of air or gas.
</p><p>Signs that can be seen on projectional radiography are shown below:
</p><p>The <i>double wall sign</i> marks the presence of air on both sides of the <a href="/wiki/Intestine" class="mw-redirect" title="Intestine">intestine</a>.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19">[19]</a></sup> However, a false double wall sign can result from two loops of bowel being in contact with one another.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20">[20]</a></sup> The sign is named after <a href="/wiki/Leo_George_Rigler" title="Leo George Rigler">Leo George Rigler</a>.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21">[21]</a></sup> It is not the same as <a href="/wiki/Rigler%27s_triad" title="Rigler's triad">Rigler's triad</a>.
</p><p>The <i>football sign</i> is when the abdomen appears as a large oval <a href="/wiki/Radiodensity" title="Radiodensity">radiolucency</a> reminiscent of an <a href="/wiki/Football_(ball)#American_and_Canadian_football" title="Football (ball)">American football</a> on a supine projectional radiograph.<sup id="cite_ref-pmid14990817_22-0" class="reference"><a href="#cite_note-pmid14990817-22">[22]</a></sup> The football sign is most frequently seen in <a href="/wiki/Infant" title="Infant">infants</a> with spontaneous or <a href="/wiki/Iatrogenic" class="mw-redirect" title="Iatrogenic">iatrogenic</a> <a href="/wiki/Gastric_perforation" class="mw-redirect" title="Gastric perforation">gastric perforation</a> causing pneumoperitoneum. It is also seen in bowel obstruction with secondary perforation, as in <a href="/wiki/Hirschprung_disease" class="mw-redirect" title="Hirschprung disease">Hirschprung disease</a>, midgut volvulus, <a href="/wiki/Meconium_ileus" class="mw-redirect" title="Meconium ileus">meconium ileus</a> and <a href="/wiki/Intestinal_atresia" title="Intestinal atresia">intestinal atresia</a>. Iatrogenic causes like endoscopic perforation may also give football sign.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (August 2020)">citation needed</span></a></i>]</sup>
</p><p>The <i>Cupola sign</i> is seen when air is accumulated under the central tendon of the diaphragm.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23">[23]</a></sup>
</p>
<ul class="gallery mw-gallery-packed">
<li class="gallerybox" style="width: 268px">
<div class="thumb" style="width: 266px;"><span typeof="mw:File"><a href="/wiki/File:Pneumoperitoneum_chest_X-ray.jpg" class="mw-file-description" title="Another pneumoperitoneum on chest X-ray."><img alt="Another pneumoperitoneum on chest X-ray." src="//upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Pneumoperitoneum_chest_X-ray.jpg/399px-Pneumoperitoneum_chest_X-ray.jpg" decoding="async" width="266" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Pneumoperitoneum_chest_X-ray.jpg/598px-Pneumoperitoneum_chest_X-ray.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Pneumoperitoneum_chest_X-ray.jpg/797px-Pneumoperitoneum_chest_X-ray.jpg 2x" data-file-width="2556" data-file-height="2116" /></a></span></div>
<div class="gallerytext">Another pneumoperitoneum on chest X-ray.</div>
</li>
<li class="gallerybox" style="width: 269.33333333333px">
<div class="thumb" style="width: 267.33333333333px;"><span typeof="mw:File"><a href="/wiki/File:Pneumoperitoneum_lateral_decubitus.jpg" class="mw-file-description" title="Pneumoperitoneum seen on X-ray with the patient lying on his left side."><img alt="Pneumoperitoneum seen on X-ray with the patient lying on his left side." src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c1/Pneumoperitoneum_lateral_decubitus.jpg/401px-Pneumoperitoneum_lateral_decubitus.jpg" decoding="async" width="268" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c1/Pneumoperitoneum_lateral_decubitus.jpg/602px-Pneumoperitoneum_lateral_decubitus.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c1/Pneumoperitoneum_lateral_decubitus.jpg/803px-Pneumoperitoneum_lateral_decubitus.jpg 2x" data-file-width="2520" data-file-height="2072" /></a></span></div>
<div class="gallerytext">Pneumoperitoneum seen on X-ray with the patient lying on his left side.</div>
</li>
<li class="gallerybox" style="width: 270.66666666667px">
<div class="thumb" style="width: 268.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:Double_wall_sign_annotated.jpg" class="mw-file-description" title="Double wall sign. This is a secondary sign of pneumoperitoneum. Patient is supine, and air within the abdomen and lumen of the bowel accentuate both sides of the bowel wall."><img alt="Double wall sign. This is a secondary sign of pneumoperitoneum. Patient is supine, and air within the abdomen and lumen of the bowel accentuate both sides of the bowel wall." src="//upload.wikimedia.org/wikipedia/commons/thumb/1/1b/Double_wall_sign_annotated.jpg/403px-Double_wall_sign_annotated.jpg" decoding="async" width="269" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/1b/Double_wall_sign_annotated.jpg/605px-Double_wall_sign_annotated.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/1b/Double_wall_sign_annotated.jpg/806px-Double_wall_sign_annotated.jpg 2x" data-file-width="2889" data-file-height="2365" /></a></span></div>
<div class="gallerytext">Double wall sign. This is a secondary sign of pneumoperitoneum. Patient is supine, and air within the abdomen and lumen of the bowel accentuate both sides of the bowel wall.</div>
</li>
<li class="gallerybox" style="width: 296.66666666667px">
<div class="thumb" style="width: 294.66666666667px;"><span typeof="mw:File"><span><video id="mwe_player_0" poster="//upload.wikimedia.org/wikipedia/commons/thumb/8/87/UOTW_68_-_Ultrasound_of_the_Week_2.webm/442px--UOTW_68_-_Ultrasound_of_the_Week_2.webm.jpg" controls="" preload="none" class="mw-file-element" width="295" height="220" data-durationhint="5" data-mwtitle="UOTW_68_-_Ultrasound_of_the_Week_2.webm" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/8/87/UOTW_68_-_Ultrasound_of_the_Week_2.webm" type="video/webm; codecs="vp9, vorbis"" data-width="530" data-height="396" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/87/UOTW_68_-_Ultrasound_of_the_Week_2.webm/UOTW_68_-_Ultrasound_of_the_Week_2.webm.m3u8" type="application/vnd.apple.mpegurl" data-transcodekey="m3u8" data-width="0" data-height="0" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/87/UOTW_68_-_Ultrasound_of_the_Week_2.webm/UOTW_68_-_Ultrasound_of_the_Week_2.webm.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="322" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/87/UOTW_68_-_Ultrasound_of_the_Week_2.webm/UOTW_68_-_Ultrasound_of_the_Week_2.webm.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="482" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/87/UOTW_68_-_Ultrasound_of_the_Week_2.webm/UOTW_68_-_Ultrasound_of_the_Week_2.webm.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="482" data-height="360" /></video></span></span></div>
<div class="gallerytext">Ultrasound finding of pneumoperitoneum known as "peritoneal stripe sign"<sup id="cite_ref-24" class="reference"><a href="#cite_note-24">[24]</a></sup></div>
</li>
</ul>
<h3><span class="mw-headline" id="Differential_diagnosis">Differential diagnosis</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pneumoperitoneum&action=edit&section=4" title="Edit section: Differential diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h3>
<p>As differential diagnoses, a <a href="/wiki/Subphrenic_abscess" title="Subphrenic abscess">subphrenic abscess</a>, bowel interposed between diaphragm and liver (<a href="/wiki/Chilaiditi_syndrome" title="Chilaiditi syndrome">Chilaiditi syndrome</a>), and linear <a href="/wiki/Atelectasis" title="Atelectasis">atelectasis</a> at the base of the lungs can simulate free air under the diaphragm on a chest X-ray.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (August 2020)">citation needed</span></a></i>]</sup>
</p>
<h2><span class="mw-headline" id="Treatment">Treatment</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pneumoperitoneum&action=edit&section=5" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<p>Treatment depends on the cause of the condition.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (August 2020)">citation needed</span></a></i>]</sup>
</p>
<h2><span class="mw-headline" id="Terminology">Terminology</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pneumoperitoneum&action=edit&section=6" title="Edit section: Terminology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<p>Pneumoperitoneum can be described as peritoneal emphysema,<sup id="cite_ref-pmid_25803061_25-0" class="reference"><a href="#cite_note-pmid_25803061-25">[25]</a></sup> just as <a href="/wiki/Pneumomediastinum" title="Pneumomediastinum">pneumomediastinum</a> can be called mediastinal emphysema, but <i>pneumoperitoneum</i> is the usual name.
</p>
<h2><span class="mw-headline" id="See_also">See also</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pneumoperitoneum&action=edit&section=7" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
<ul><li><a href="/wiki/Cupola_sign" title="Cupola sign">Cupola sign</a></li>
<li><a href="/wiki/Football_sign" class="mw-redirect" title="Football sign">Football sign</a></li>
<li><a href="/wiki/Pneumoretroperitoneum" title="Pneumoretroperitoneum">Pneumoretroperitoneum</a></li>
<li><a href="/wiki/Rigler%27s_sign" class="mw-redirect" title="Rigler's sign">Rigler's sign</a></li></ul>
<h2><span class="mw-headline" id="References">References</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pneumoperitoneum&action=edit&section=8" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
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<li id="cite_note-18"><span class="mw-cite-backlink"><b><a href="#cite_ref-18">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFKhanChandramohan2017" class="citation journal cs1">Khan AN, Chandramohan M (2017-12-06). Coombs BD, Gay SD (eds.). <a rel="nofollow" class="external text" href="http://www.emedicine.com/radio/topic562.htm">"Pneumoperitoneum Imaging"</a>. <i>Emedicine, Medscape</i>. WebMD LLC.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Emedicine%2C+Medscape&rft.atitle=Pneumoperitoneum+Imaging&rft.date=2017-12-06&rft.aulast=Khan&rft.aufirst=AN&rft.au=Chandramohan%2C+M&rft_id=http%3A%2F%2Fwww.emedicine.com%2Fradio%2Ftopic562.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3APneumoperitoneum" class="Z3988"></span></span>
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<li id="cite_note-19"><span class="mw-cite-backlink"><b><a href="#cite_ref-19">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFHarkinBlake1999" class="citation journal cs1">Harkin DW, Blake G (March 1999). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1741173">"Small bowel obstruction in a young adult"</a>. <i>Postgraduate Medical Journal</i>. <b>75</b> (881): 173–5. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fpgmj.75.881.173">10.1136/pgmj.75.881.173</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1741173">1741173</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10448501">10448501</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Postgraduate+Medical+Journal&rft.atitle=Small+bowel+obstruction+in+a+young+adult&rft.volume=75&rft.issue=881&rft.pages=173-5&rft.date=1999-03&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1741173%23id-name%3DPMC&rft_id=info%3Apmid%2F10448501&rft_id=info%3Adoi%2F10.1136%2Fpgmj.75.881.173&rft.aulast=Harkin&rft.aufirst=DW&rft.au=Blake%2C+G&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1741173&rfr_id=info%3Asid%2Fen.wikipedia.org%3APneumoperitoneum" class="Z3988"></span></span>
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<li id="cite_note-20"><span class="mw-cite-backlink"><b><a href="#cite_ref-20">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFde_LaceyBloombergWignall1977" class="citation journal cs1">de Lacey G, Bloomberg T, Wignall BK (July 1977). "Pneumoperitoneum: the misleading double wall sign". <i>Clinical Radiology</i>. <b>28</b> (4): 445–8. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fs0009-9260%2877%2980161-x">10.1016/s0009-9260(77)80161-x</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/872511">872511</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinical+Radiology&rft.atitle=Pneumoperitoneum%3A+the+misleading+double+wall+sign&rft.volume=28&rft.issue=4&rft.pages=445-8&rft.date=1977-07&rft_id=info%3Adoi%2F10.1016%2Fs0009-9260%2877%2980161-x&rft_id=info%3Apmid%2F872511&rft.aulast=de+Lacey&rft.aufirst=G&rft.au=Bloomberg%2C+T&rft.au=Wignall%2C+BK&rfr_id=info%3Asid%2Fen.wikipedia.org%3APneumoperitoneum" class="Z3988"></span></span>
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<li id="cite_note-21"><span class="mw-cite-backlink"><b><a href="#cite_ref-21">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFHirschCortés2009" class="citation journal cs1 cs1-prop-foreign-lang-source">Hirsch M, Cortés C (2009). <a rel="nofollow" class="external text" href="https://doi.org/10.4067%2FS0717-93082009000300008">"El signo de Leo Rigler: doble pared en neumoperitoneo"</a> [The sign of Leo Rigler: double pared in neumoperitoneo.]. <i>Revista chilena de radiología</i> (in Spanish). <b>15</b> (3): 152–4. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.4067%2FS0717-93082009000300008">10.4067/S0717-93082009000300008</a></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Revista+chilena+de+radiolog%C3%ADa&rft.atitle=El+signo+de+Leo+Rigler%3A+doble+pared+en+neumoperitoneo.&rft.volume=15&rft.issue=3&rft.pages=152-4&rft.date=2009&rft_id=info%3Adoi%2F10.4067%2FS0717-93082009000300008&rft.aulast=Hirsch&rft.aufirst=M&rft.au=Cort%C3%A9s%2C+C&rft_id=https%3A%2F%2Fdoi.org%2F10.4067%252FS0717-93082009000300008&rfr_id=info%3Asid%2Fen.wikipedia.org%3APneumoperitoneum" class="Z3988"></span></span>
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<li id="cite_note-pmid14990817-22"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid14990817_22-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFRampton2004" class="citation journal cs1">Rampton JW (April 2004). "The football sign". <i>Radiology</i>. <b>231</b> (1): 81–2. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1148%2Fradiol.2311011290">10.1148/radiol.2311011290</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14990817">14990817</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Radiology&rft.atitle=The+football+sign&rft.volume=231&rft.issue=1&rft.pages=81-2&rft.date=2004-04&rft_id=info%3Adoi%2F10.1148%2Fradiol.2311011290&rft_id=info%3Apmid%2F14990817&rft.aulast=Rampton&rft.aufirst=JW&rfr_id=info%3Asid%2Fen.wikipedia.org%3APneumoperitoneum" class="Z3988"></span></span>
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<li id="cite_note-23"><span class="mw-cite-backlink"><b><a href="#cite_ref-23">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFSurekaBansalArora2015" class="citation journal cs1">Sureka B, Bansal K, Arora A (2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535122">"Pneumoperitoneum: What to look for in a radiograph?"</a>. <i>Journal of Family Medicine and Primary Care</i>. <b>4</b> (3): 477–8. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.4103%2F2249-4863.161369">10.4103/2249-4863.161369</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535122">4535122</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26288798">26288798</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Family+Medicine+and+Primary+Care&rft.atitle=Pneumoperitoneum%3A+What+to+look+for+in+a+radiograph%3F&rft.volume=4&rft.issue=3&rft.pages=477-8&rft.date=2015&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4535122%23id-name%3DPMC&rft_id=info%3Apmid%2F26288798&rft_id=info%3Adoi%2F10.4103%2F2249-4863.161369&rft.aulast=Sureka&rft.aufirst=B&rft.au=Bansal%2C+K&rft.au=Arora%2C+A&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4535122&rfr_id=info%3Asid%2Fen.wikipedia.org%3APneumoperitoneum" class="Z3988"></span></span>
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<li id="cite_note-24"><span class="mw-cite-backlink"><b><a href="#cite_ref-24">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.ultrasoundoftheweek.com/uotw-68/">"UOTW #68 - Ultrasound of the Week"</a>. <i>Ultrasound of the Week</i>. 22 March 2016<span class="reference-accessdate">. Retrieved <span class="nowrap">27 May</span> 2017</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Ultrasound+of+the+Week&rft.atitle=UOTW+%2368+-+Ultrasound+of+the+Week&rft.date=2016-03-22&rft_id=https%3A%2F%2Fwww.ultrasoundoftheweek.com%2Fuotw-68%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3APneumoperitoneum" class="Z3988"></span></span>
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<li id="cite_note-pmid_25803061-25"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid_25803061_25-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215172403"><cite id="CITEREFMarianMonikaBartosz2015" class="citation journal cs1">Marian K, Monika K, Bartosz K (March 2015). "Spontaneous pneumoperitoneum in a patient after ventilation therapy". <i>Polski Przeglad Chirurgiczny</i>. <b>86</b> (12): 601–3. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1515%2Fpjs-2015-0008">10.1515/pjs-2015-0008</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25803061">25803061</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Polski+Przeglad+Chirurgiczny&rft.atitle=Spontaneous+pneumoperitoneum+in+a+patient+after+ventilation+therapy&rft.volume=86&rft.issue=12&rft.pages=601-3&rft.date=2015-03&rft_id=info%3Adoi%2F10.1515%2Fpjs-2015-0008&rft_id=info%3Apmid%2F25803061&rft.aulast=Marian&rft.aufirst=K&rft.au=Monika%2C+K&rft.au=Bartosz%2C+K&rfr_id=info%3Asid%2Fen.wikipedia.org%3APneumoperitoneum" class="Z3988"></span></span>
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</ol></div></div>
<h2><span class="mw-headline" id="External_links">External links</span><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pneumoperitoneum&action=edit&section=9" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></h2>
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margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q163469" class="extiw" title="d:Q163469">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/K66.8">K66.8</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=568.89">568.89</a>, <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=770.2">770.2</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D011027">D011027</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb31511.htm">31511</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/radio/562-overview">radio/562</a></li></ul></div></div></td></tr></tbody></table></div>
<div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1061467846"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_the_human_digestive_system" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1063604349">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Digestive_system_diseases" title="Template:Digestive system diseases"><abbr title="View this template" style=";;background:none transparent;border:none;box-shadow:none;padding:0;">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Digestive_system_diseases" title="Template talk:Digestive system diseases"><abbr title="Discuss this template" style=";;background:none transparent;border:none;box-shadow:none;padding:0;">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Digestive_system_diseases" title="Special:EditPage/Template:Digestive system diseases"><abbr title="Edit this template" style=";;background:none transparent;border:none;box-shadow:none;padding:0;">e</abbr></a></li></ul></div><div id="Diseases_of_the_human_digestive_system" style="font-size:114%;margin:0 4em">Diseases of the <a href="/wiki/Human_digestive_system" title="Human digestive system">human digestive system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_tract#Upper_gastrointestinal_tract" title="Gastrointestinal tract">Upper GI tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Esophageal_disease" title="Esophageal disease">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Esophagitis" title="Esophagitis">Esophagitis</a>
<ul><li><a href="/wiki/Esophageal_candidiasis" title="Esophageal candidiasis">Candidal</a></li>
<li><a href="/wiki/Eosinophilic_esophagitis" title="Eosinophilic esophagitis">Eosinophilic</a></li>
<li><a href="/wiki/Herpetiform_esophagitis" class="mw-redirect" title="Herpetiform esophagitis">Herpetiform</a></li></ul></li>
<li><i>Rupture</i>
<ul><li><a href="/wiki/Boerhaave_syndrome" class="mw-redirect" title="Boerhaave syndrome">Boerhaave syndrome</a></li>
<li><a href="/wiki/Mallory%E2%80%93Weiss_syndrome" title="Mallory–Weiss syndrome">Mallory–Weiss syndrome</a></li></ul></li>
<li><a href="/wiki/Zenker%27s_diverticulum" title="Zenker's diverticulum">Zenker's diverticulum</a></li>
<li><a href="/wiki/Barrett%27s_esophagus" title="Barrett's esophagus">Barrett's esophagus</a></li>
<li><a href="/wiki/Esophageal_motility_disorder" title="Esophageal motility disorder">Esophageal motility disorder</a>
<ul><li><a href="/wiki/Nutcracker_esophagus" title="Nutcracker esophagus">Nutcracker esophagus</a></li>
<li><a href="/wiki/Achalasia" class="mw-redirect" title="Achalasia">Achalasia</a></li>
<li><a href="/wiki/Esophagogastric_junction_outflow_obstruction" title="Esophagogastric junction outflow obstruction">Esophagogastric junction outflow obstruction</a></li>
<li><a href="/wiki/Diffuse_esophageal_spasm" title="Diffuse esophageal spasm">Diffuse esophageal spasm</a></li>
<li><a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">Gastroesophageal reflux disease</a> (GERD)</li></ul></li>
<li><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</li>
<li><a href="/wiki/Esophageal_stricture" title="Esophageal stricture">Esophageal stricture</a></li>
<li><a href="/wiki/Esophageal_inlet_patch" title="Esophageal inlet patch">Inlet patch</a></li>
<li><a href="/wiki/Megaesophagus" title="Megaesophagus">Megaesophagus</a></li>
<li><a href="/wiki/Esophageal_intramural_pseudodiverticulosis" title="Esophageal intramural pseudodiverticulosis">Esophageal intramural pseudodiverticulosis</a></li>
<li><a href="/wiki/Acute_esophageal_necrosis" title="Acute esophageal necrosis">Acute esophageal necrosis</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Stomach_disease" title="Stomach disease">Stomach</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Gastritis" title="Gastritis">Gastritis</a>
<ul><li><a href="/wiki/Atrophic_gastritis" title="Atrophic gastritis">Atrophic</a></li>
<li><a href="/wiki/M%C3%A9n%C3%A9trier%27s_disease" title="Ménétrier's disease">Ménétrier's disease</a></li>
<li><a href="/wiki/Gastroenteritis" title="Gastroenteritis">Gastroenteritis</a></li></ul></li>
<li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (gastric) ulcer</a>
<ul><li><a href="/wiki/Cushing_ulcer" title="Cushing ulcer">Cushing ulcer</a></li>
<li><a href="/wiki/Dieulafoy%27s_lesion" title="Dieulafoy's lesion">Dieulafoy's lesion</a></li></ul></li>
<li><a href="/wiki/Dyspepsia" class="mw-redirect" title="Dyspepsia">Dyspepsia</a>
<ul><li><a href="/wiki/Functional_dyspepsia" title="Functional dyspepsia">Functional dyspepsia</a></li></ul></li>
<li><a href="/wiki/Pyloric_stenosis" title="Pyloric stenosis">Pyloric stenosis</a></li>
<li><a href="/wiki/Achlorhydria" title="Achlorhydria">Achlorhydria</a></li>
<li><a href="/wiki/Gastroparesis" title="Gastroparesis">Gastroparesis</a></li>
<li><a href="/wiki/Gastroptosis" title="Gastroptosis">Gastroptosis</a></li>
<li><a href="/wiki/Portal_hypertensive_gastropathy" title="Portal hypertensive gastropathy">Portal hypertensive gastropathy</a></li>
<li><a href="/wiki/Gastric_antral_vascular_ectasia" title="Gastric antral vascular ectasia">Gastric antral vascular ectasia</a></li>
<li><a href="/wiki/Gastric_dumping_syndrome" class="mw-redirect" title="Gastric dumping syndrome">Gastric dumping syndrome</a></li>
<li><a href="/wiki/Gastric_volvulus" title="Gastric volvulus">Gastric volvulus</a></li>
<li><a href="/wiki/Buried_bumper_syndrome" title="Buried bumper syndrome">Buried bumper syndrome</a></li>
<li><a href="/wiki/Gastrinoma" title="Gastrinoma">Gastrinoma</a>
<ul><li><a href="/wiki/Zollinger%E2%80%93Ellison_syndrome" title="Zollinger–Ellison syndrome">Zollinger–Ellison syndrome</a></li></ul></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_tract#Lower_gastrointestinal_tract" title="Gastrointestinal tract">Lower GI tract</a> <br /> <a href="/wiki/Enteropathy" title="Enteropathy">Enteropathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Small_intestine" title="Small intestine">Small intestine</a> <br /> (<a href="/wiki/Duodenum" title="Duodenum">Duodenum</a>/<a href="/wiki/Jejunum" title="Jejunum">Jejunum</a>/<a href="/wiki/Ileum" title="Ileum">Ileum</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Enteritis" title="Enteritis">Enteritis</a>
<ul><li><a href="/wiki/Duodenitis" title="Duodenitis">Duodenitis</a></li>
<li><a href="/wiki/Jejunitis" title="Jejunitis">Jejunitis</a></li>
<li><a href="/wiki/Ileitis" title="Ileitis">Ileitis</a></li></ul></li>
<li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (duodenal) ulcer</a>
<ul><li><a href="/wiki/Curling%27s_ulcer" title="Curling's ulcer">Curling's ulcer</a></li></ul></li>
<li><a href="/wiki/Malabsorption" title="Malabsorption">Malabsorption</a>: <a href="/wiki/Coeliac_disease" title="Coeliac disease">Coeliac</a></li>
<li><a href="/wiki/Tropical_sprue" title="Tropical sprue">Tropical sprue</a></li>
<li><a href="/wiki/Blind_loop_syndrome" title="Blind loop syndrome">Blind loop syndrome</a></li>
<li><a href="/wiki/Small_intestinal_bacterial_overgrowth" title="Small intestinal bacterial overgrowth">Small intestinal bacterial overgrowth</a></li>
<li><a href="/wiki/Whipple%27s_disease" title="Whipple's disease">Whipple's</a></li>
<li><a href="/wiki/Short_bowel_syndrome" title="Short bowel syndrome">Short bowel syndrome</a></li>
<li><a href="/wiki/Steatorrhea" title="Steatorrhea">Steatorrhea</a></li>
<li><a href="/wiki/Milroy_disease" class="mw-redirect" title="Milroy disease">Milroy disease</a></li>
<li><a href="/wiki/Bile_acid_malabsorption" title="Bile acid malabsorption">Bile acid malabsorption</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Large_intestine" title="Large intestine">Large intestine</a> <br /> (<a href="/wiki/Vermiform_appendix" class="mw-redirect" title="Vermiform appendix">Appendix</a>/<a href="/wiki/Colon_(anatomy)" class="mw-redirect" title="Colon (anatomy)">Colon</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Appendicitis" title="Appendicitis">Appendicitis</a></li>
<li><a href="/wiki/Colitis" title="Colitis">Colitis</a>
<ul><li><a href="/wiki/Pseudomembranous_colitis" class="mw-redirect" title="Pseudomembranous colitis">Pseudomembranous</a></li>
<li><a href="/wiki/Ulcerative_colitis" title="Ulcerative colitis">Ulcerative</a></li>
<li><a href="/wiki/Ischemic_colitis" title="Ischemic colitis">Ischemic</a></li>
<li><a href="/wiki/Microscopic_colitis" title="Microscopic colitis">Microscopic</a></li>
<li><a href="/wiki/Collagenous_colitis" title="Collagenous colitis">Collagenous</a></li>
<li><a href="/wiki/Lymphocytic_colitis" title="Lymphocytic colitis">Lymphocytic</a></li></ul></li>
<li><a href="/wiki/Dysentery" title="Dysentery">Dysentery</a></li>
<li><a href="/wiki/Functional_colonic_disease" class="mw-redirect" title="Functional colonic disease">Functional colonic disease</a>
<ul><li><a href="/wiki/Irritable_bowel_syndrome" title="Irritable bowel syndrome">IBS</a></li>
<li><a href="/wiki/Intestinal_pseudoobstruction" class="mw-redirect" title="Intestinal pseudoobstruction">Intestinal pseudoobstruction</a> / <a href="/wiki/Ogilvie_syndrome" title="Ogilvie syndrome">Ogilvie syndrome</a></li></ul></li>
<li><a href="/wiki/Megacolon" title="Megacolon">Megacolon</a> / <a href="/wiki/Toxic_megacolon" title="Toxic megacolon">Toxic megacolon</a></li>
<li><a href="/wiki/Diverticulitis" title="Diverticulitis">Diverticulitis</a>/<a href="/wiki/Diverticulosis" title="Diverticulosis">Diverticulosis</a>/<a href="/wiki/Segmental_colitis_associated_with_diverticulosis" title="Segmental colitis associated with diverticulosis">SCAD</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Large and/or small</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Enterocolitis" title="Enterocolitis">Enterocolitis</a>
<ul><li><a href="/wiki/Necrotizing_enterocolitis" title="Necrotizing enterocolitis">Necrotizing</a></li></ul></li>
<li><a href="/wiki/Gastroenterocolitis" title="Gastroenterocolitis">Gastroenterocolitis</a></li>
<li><a href="/wiki/Inflammatory_bowel_disease" title="Inflammatory bowel disease">IBD</a>
<ul><li><a href="/wiki/Crohn%27s_disease" title="Crohn's disease">Crohn's disease</a></li></ul></li>
<li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i>: <a href="/wiki/Abdominal_angina" title="Abdominal angina">Abdominal angina</a></li>
<li><a href="/wiki/Mesenteric_ischemia" class="mw-redirect" title="Mesenteric ischemia">Mesenteric ischemia</a></li>
<li><a href="/wiki/Angiodysplasia" title="Angiodysplasia">Angiodysplasia</a></li>
<li><a href="/wiki/Bowel_obstruction" title="Bowel obstruction">Bowel obstruction</a>: <a href="/wiki/Ileus" title="Ileus">Ileus</a></li>
<li><a href="/wiki/Intussusception_(medical_disorder)" title="Intussusception (medical disorder)">Intussusception</a></li>
<li><a href="/wiki/Volvulus" title="Volvulus">Volvulus</a></li>
<li><a href="/wiki/Fecal_impaction" title="Fecal impaction">Fecal impaction</a></li>
<li><a href="/wiki/Constipation" title="Constipation">Constipation</a></li>
<li><a href="/wiki/Diarrhea" title="Diarrhea">Diarrhea</a>
<ul><li><a href="/wiki/Infectious_diarrhea" class="mw-redirect" title="Infectious diarrhea">Infectious</a></li></ul></li>
<li><a href="/wiki/Adhesion_(medicine)" title="Adhesion (medicine)">Intestinal adhesions</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rectum" title="Rectum">Rectum</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Proctitis" title="Proctitis">Proctitis</a>
<ul><li><a href="/wiki/Radiation_proctitis" title="Radiation proctitis">Radiation proctitis</a></li></ul></li>
<li><a href="/wiki/Proctalgia_fugax" title="Proctalgia fugax">Proctalgia fugax</a></li>
<li><a href="/wiki/Rectal_prolapse" title="Rectal prolapse">Rectal prolapse</a></li>
<li><a href="/wiki/Anismus" title="Anismus">Anismus</a></li>
<li><a href="/wiki/Solitary_rectal_ulcer_syndrome" title="Solitary rectal ulcer syndrome">Solitary rectal ulcer syndrome</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anal_canal" title="Anal canal">Anal canal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Anal_fissure" title="Anal fissure">Anal fissure</a>/<a href="/wiki/Anal_fistula" title="Anal fistula">Anal fistula</a></li>
<li><a href="/wiki/Anal_abscess" class="mw-redirect" title="Anal abscess">Anal abscess</a></li>
<li><a href="/wiki/Hemorrhoid" title="Hemorrhoid">Hemorrhoid</a></li>
<li><a href="/wiki/Anal_dysplasia" title="Anal dysplasia">Anal dysplasia</a></li>
<li><a href="/wiki/Pruritus_ani" title="Pruritus ani">Pruritus ani</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_bleeding" title="Gastrointestinal bleeding">GI bleeding</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Blood_in_stool" title="Blood in stool">Blood in stool</a></li>
<li><a href="/wiki/Upper_gastrointestinal_bleeding" title="Upper gastrointestinal bleeding">Upper</a>
<ul><li><a href="/wiki/Hematemesis" title="Hematemesis">Hematemesis</a></li>
<li><a href="/wiki/Melena" title="Melena">Melena</a></li></ul></li>
<li><a href="/wiki/Lower_gastrointestinal_bleeding" title="Lower gastrointestinal bleeding">Lower</a>
<ul><li><a href="/wiki/Hematochezia" title="Hematochezia">Hematochezia</a></li></ul></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Accessory_digestive_gland" class="mw-redirect" title="Accessory digestive gland">Accessory</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Liver_disease" title="Liver disease">Liver</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Hepatitis" title="Hepatitis">Hepatitis</a>
<ul><li><a href="/wiki/Viral_hepatitis" title="Viral hepatitis">Viral hepatitis</a></li>
<li><a href="/wiki/Autoimmune_hepatitis" title="Autoimmune hepatitis">Autoimmune hepatitis</a></li>
<li><a href="/wiki/Alcoholic_hepatitis" title="Alcoholic hepatitis">Alcoholic hepatitis</a></li></ul></li>
<li><a href="/wiki/Cirrhosis" title="Cirrhosis">Cirrhosis</a>
<ul><li><a href="/wiki/Primary_biliary_cirrhosis" class="mw-redirect" title="Primary biliary cirrhosis">PBC</a></li></ul></li>
<li><a href="/wiki/Fatty_liver" class="mw-redirect" title="Fatty liver">Fatty liver</a>
<ul><li><a href="/wiki/Metabolic_dysfunction%E2%80%93associated_steatotic_liver_disease" title="Metabolic dysfunction–associated steatotic liver disease">MASLD</a></li></ul></li>
<li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i>
<ul><li><a href="/wiki/Budd%E2%80%93Chiari_syndrome" title="Budd–Chiari syndrome">Budd–Chiari syndrome</a></li>
<li><a href="/wiki/Hepatic_veno-occlusive_disease" title="Hepatic veno-occlusive disease">Hepatic veno-occlusive disease</a></li>
<li><a href="/wiki/Portal_hypertension" title="Portal hypertension">Portal hypertension</a></li>
<li><a href="/wiki/Nutmeg_liver" class="mw-redirect" title="Nutmeg liver">Nutmeg liver</a></li></ul></li>
<li><a href="/wiki/Alcoholic_liver_disease" title="Alcoholic liver disease">Alcoholic liver disease</a></li>
<li><a href="/wiki/Liver_failure" title="Liver failure">Liver failure</a>
<ul><li><a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">Hepatic encephalopathy</a></li>
<li><a href="/wiki/Acute_liver_failure" title="Acute liver failure">Acute liver failure</a></li></ul></li>
<li><a href="/wiki/Liver_abscess" title="Liver abscess">Liver abscess</a>
<ul><li><a href="/wiki/Pyogenic_liver_abscess" title="Pyogenic liver abscess">Pyogenic</a></li>
<li><a href="/wiki/Amoebic_liver_abscess" title="Amoebic liver abscess">Amoebic</a></li></ul></li>
<li><a href="/wiki/Hepatorenal_syndrome" title="Hepatorenal syndrome">Hepatorenal syndrome</a></li>
<li><a href="/wiki/Peliosis_hepatis" title="Peliosis hepatis">Peliosis hepatis</a></li>
<li><a href="/wiki/Metabolic_disorder" title="Metabolic disorder">Metabolic disorders</a>
<ul><li><a href="/wiki/Wilson%27s_disease" title="Wilson's disease">Wilson's disease</a></li>
<li><a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">Hemochromatosis</a></li></ul></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gallbladder_disease" title="Gallbladder disease">Gallbladder</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Cholecystitis" title="Cholecystitis">Cholecystitis</a></li>
<li><a href="/wiki/Gallstone" title="Gallstone">Gallstone / Cholelithiasis</a></li>
<li><a href="/wiki/Cholesterolosis_of_gallbladder" title="Cholesterolosis of gallbladder">Cholesterolosis</a></li>
<li><a href="/wiki/Adenomyomatosis" title="Adenomyomatosis">Adenomyomatosis</a></li>
<li><a href="/wiki/Postcholecystectomy_syndrome" title="Postcholecystectomy syndrome">Postcholecystectomy syndrome</a></li>
<li><a href="/wiki/Porcelain_gallbladder" title="Porcelain gallbladder">Porcelain gallbladder</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bile_duct" title="Bile duct">Bile duct</a>/ <br /> Other <a href="/wiki/Biliary_tree" class="mw-redirect" title="Biliary tree">biliary tree</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Cholangitis" class="mw-redirect" title="Cholangitis">Cholangitis</a>
<ul><li><a href="/wiki/Primary_sclerosing_cholangitis" title="Primary sclerosing cholangitis">Primary sclerosing cholangitis</a></li>
<li><a href="/wiki/Secondary_sclerosing_cholangitis" title="Secondary sclerosing cholangitis">Secondary sclerosing cholangitis</a></li>
<li><a href="/wiki/Ascending_cholangitis" title="Ascending cholangitis">Ascending</a></li></ul></li>
<li><a href="/wiki/Cholestasis" title="Cholestasis">Cholestasis</a>/<a href="/wiki/Mirizzi%27s_syndrome" title="Mirizzi's syndrome">Mirizzi's syndrome</a></li>
<li><a href="/wiki/Biliary_fistula" title="Biliary fistula">Biliary fistula</a></li>
<li><a href="/wiki/Haemobilia" title="Haemobilia">Haemobilia</a></li></ul>
<ul><li><i><a href="/wiki/Common_bile_duct" title="Common bile duct">Common bile duct</a></i>
<ul><li><a href="/wiki/Choledocholithiasis" class="mw-redirect" title="Choledocholithiasis">Choledocholithiasis</a></li>
<li><a href="/wiki/Biliary_dyskinesia" title="Biliary dyskinesia">Biliary dyskinesia</a></li></ul></li>
<li><a href="/wiki/Sphincter_of_Oddi_dysfunction" title="Sphincter of Oddi dysfunction">Sphincter of Oddi dysfunction</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatic_disease" title="Pancreatic disease">Pancreatic</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Pancreatitis" title="Pancreatitis">Pancreatitis</a>
<ul><li><a href="/wiki/Acute_pancreatitis" title="Acute pancreatitis">Acute</a></li>
<li><a href="/wiki/Chronic_pancreatitis" title="Chronic pancreatitis">Chronic</a></li>
<li><a href="/wiki/Hereditary_pancreatitis" title="Hereditary pancreatitis">Hereditary</a></li>
<li><a href="/wiki/Pancreatic_abscess" title="Pancreatic abscess">Pancreatic abscess</a></li></ul></li>
<li><a href="/wiki/Pancreatic_pseudocyst" title="Pancreatic pseudocyst">Pancreatic pseudocyst</a></li>
<li><a href="/wiki/Exocrine_pancreatic_insufficiency" title="Exocrine pancreatic insufficiency">Exocrine pancreatic insufficiency</a></li>
<li><a href="/wiki/Pancreatic_fistula" title="Pancreatic fistula">Pancreatic fistula</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Hernia" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hernia" title="Hernia">Hernia</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Diaphragmatic_hernia" title="Diaphragmatic hernia">Diaphragmatic</a>
<ul><li><a href="/wiki/Congenital_diaphragmatic_hernia" title="Congenital diaphragmatic hernia">Congenital</a></li></ul></li>
<li><a href="/wiki/Hiatus_hernia" class="mw-redirect" title="Hiatus hernia">Hiatus</a></li></ul>
<ul><li><a href="/wiki/Inguinal_hernia" title="Inguinal hernia">Inguinal</a>
<ul><li><a href="/wiki/Indirect_inguinal_hernia" class="mw-redirect" title="Indirect inguinal hernia">Indirect</a></li>
<li><a href="/wiki/Direct_inguinal_hernia" class="mw-redirect" title="Direct inguinal hernia">Direct</a></li></ul></li>
<li><a href="/wiki/Umbilical_hernia" title="Umbilical hernia">Umbilical</a></li>
<li><a href="/wiki/Femoral_hernia" title="Femoral hernia">Femoral</a></li>
<li><a href="/wiki/Obturator_hernia" title="Obturator hernia">Obturator</a></li>
<li><a href="/wiki/Spigelian_hernia" title="Spigelian hernia">Spigelian</a></li></ul>
<ul><li><i><a href="/wiki/Lumbar_hernia" class="mw-redirect" title="Lumbar hernia">Lumbar</a></i>
<ul><li><a href="/wiki/Petit%27s_hernia" title="Petit's hernia">Petit's</a></li>
<li><a href="/wiki/Grynfeltt%E2%80%93Lesshaft_hernia" title="Grynfeltt–Lesshaft hernia">Grynfeltt–Lesshaft</a></li></ul></li></ul>
<ul><li><i>Undefined location</i>
<ul><li><a href="/wiki/Incisional_hernia" title="Incisional hernia">Incisional</a></li>
<li><a href="/wiki/Internal_hernia" title="Internal hernia">Internal hernia</a></li>
<li><a href="/wiki/Richter%27s_hernia" title="Richter's hernia">Richter's</a></li></ul></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peritoneal_disease" class="mw-redirect" title="Peritoneal disease">Peritoneal</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="/wiki/Peritonitis" title="Peritonitis">Peritonitis</a>
<ul><li><a href="/wiki/Spontaneous_bacterial_peritonitis" title="Spontaneous bacterial peritonitis">Spontaneous bacterial peritonitis</a></li></ul></li>
<li><a href="/wiki/Hemoperitoneum" title="Hemoperitoneum">Hemoperitoneum</a></li>
<li><a class="mw-selflink selflink">Pneumoperitoneum</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr></tbody></table></div></div>' |
Whether or not the change was made through a Tor exit node (tor_exit_node) | false |
Unix timestamp of change (timestamp) | '1713980364' |
