Detection of Intraperitoneal

The upright chest film has long been considered to be the most sensitive plain film view for the recognition of tiny amounts of free air.1-3 Miller and Nelson showed that as little as 1 mL of free gas could be demonstrated in an erect patient using a horizontal x-ray beam.1 However, the real sensitivity of the upright projection has not yet been scrutinized by a prospective study. The supine film, obtained with a vertical beam, has been generally considered to be of relatively limited utility, useful only for the recognition of a relatively large amount of air. Actually, more current studies have demonstrated that the supine film is in fact extremely incisive, revealing even less than 1 mL of free air in some cases.4-7 Yet its true sensitivity also awaits confirmation by prospective analysis.

The CT scan is generally regarded as the gold standard for the recognition of free air.8-10 In a recent investigation, CT detected all small pneumoperitoneums introduced during diagnostic peritoneal lavage, whereas upright chest films missed almost two thirds of cases.8 Sonography can occasionally demonstrate extraluminal gas, but it rarely demonstrates very small accumulations of free air.11'12

Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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