Detection of pneumoperitoneum by ultrasound examination: an experimental and clinical study

Purpose of the study: the aim of the study is to show the value and reliabi lity of ultrasound examination in detecting free intraabdominal air after b lunt abdominal trauma. Methods: the experimental part of this study includes the evaluation of the sonographic morphology of air within liquid and solid tissues. Subsequentl y air was injected into the abdominal cavities of 10 cadavers and sonograph y utilized for localization and assessment of the minimal detectable air vo lume. The clinical part of the study reports on the sonographic detection of holl ow viscus perforation in 10 patients, who were admitted to our institution because of acute abdominal problems. Results: sonography is a reliable method for the diagnosis of free intraabd ominal air. Best position for ultrasound examination of the abdomen is supi ne with the thorax slightly elevated (10-20 degrees). The optimal probe pos ition is in the right paramedian epigastric area in the longitudinal direct ion. In all the 10 patients we were able to diagnose pneumoperitoneum preop eratively by ultrasound assessment. (C) 1999 Elsevier Science Ltd. All righ ts reserved.