Pseudopneumoperitoneum

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Pseudopneumoperitoneum describes any gas within the abdominal cavity that masquerades as free intraperitoneal gas or pneumoperitoneum when it is in fact contained within an organ. Correctly identifying pneumoperitoneum is important, but making the diagnosis in error may lead to further unnecessary investigation and possible treatment ¹.

Causes of pseudopneumoperitoneum include:

basal linear atelectasis
pneumomediastinum (mimicking cupola sign)
Chilaiditi sign
pseudo-Rigler sign
diaphragmatic undulation
gas within skin folds
biliary, portal vein or bowel wall gas
fat within the subdiaphragmatic space or the ligamentum teres
properitoneal fat stripe
benign post-traumatic pseudopneumoperitoneum

Image 6 Annotated image ( create )

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