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

Abstract Purpose of the study: the aim of the study is to show the value and reliability of ultrasound examination in detecting free intraabdominal air after blunt abdominal trauma. Methods: the experimental part of this study includes the evaluation of the sonographic morphology of air within liquid and solid tissues. Subsequently air was injected into the abdominal cavities of 10 cadavers and sonography utilized for localization and assessment of the minimal detectable air volume. The clinical part of the study reports on the sonographic detection of hollow 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 intraabdominal air. Best position for ultrasound examination of the abdomen is supine with the thorax slightly elevated (10–20°). The optimal probe position is in the right paramedian epigastric area in the longitudinal direction. In all the 10 patients we were able to diagnose pneumoperitoneum preoperatively by ultrasound assessment.