Pseudopneumoperitoneum in chronic intestinal pseudo-obstruction: a case report(226 views) Camera L, Calabrese M, Sarnelli G, Longobardi M, Rocco A, Cuomo R, Salvatore M
World J Gastroentero (ISSN: 2219-2840, 1007-9327, 1007-9327linking), 2011 Jun 28; 17(24): 2972-2975.
Department of Bio-morphological and Functional Sciences, University Federico II, 80131 Naples, Italy. camera@unina.it
Institute of Bioimages and Biostructures, National Research Council, 80131 Naples, Italy
Department of Clinical and Experimental Medicine, Gastroenterology Unit, University Federico II, 80131 Naples, Italy
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Miller, R.E., The radiological evaluation of intraperitoneal gas (pneumoperitoneum) (1973) CRC Crit Rev Clin Radiol Nucl Med, 4, pp. 61-85
Mokrohisky, J.F., Pseudopneumoperitoneum
Fisher, M.S., The simulation of pneumoperitoneum by basal atelectasis (1968) Br J Radiol, 41, p. 701
Kim, H.W., Chon, N.R., Kim, Y.S., Kim, J.H., Park, H., A case of spontaneous pneumoperitoneum associated with idiopathic intestinal pseudoobstruction (2009) Korean J Gastroenterol, 54, pp. 395-398
Levine, M.S., Scheiner, J.D., Rubesin, S.E., Laufer, I., Herlinger, H., Diagnosis of pneumoperitoneum on supine abdominal radiographs (1991) AJR Am J Roentgenol, 156, pp. 731-735
Rigler, L.G., Spontaneous pneumoperitoneum: A roentgenologic sign found in the supine position (1941) Radiology, 37, pp. 604-607
Weiner, C.I., Diaconis, J.N., Dennis, J.M., The "inverted V": A new sign of pneumoperitoneum (1973) Radiology, 107, pp. 47-48
Cho, K.C., Baker, S.R., Visualization of the extrahepatic segment of the ligamentum teres: A sign of free air on plain radiographs (1997) Radiology, 202, pp. 651-654
Chiu, Y.H., Chen, J.D., Tiu, C.M., Chou, Y.H., Yen, D.H., Huang, C.I., Chang, C.Y., Reappraisal of radiographic signs of pneumoperitoneum at emergency department (2009) Am J Emerg Med, 27, pp. 320-327
Ly, J.Q., The Rigler sign (2003) Radiology, 228, pp. 706-707
Ly, J.Q., Visibility of the inferior heart border in pneumoperitoneum (1981) AJR Am J Roentgenol, 137, pp. 622-623
Kim, H.J., Kim, A.Y., Lee, C.W., Yu, C.S., Kim, J.S., Kim, P.N., Lee, M.G., Ha, H.K., Hirschsprung disease and hypoganglionosis in adults: Radiologic findings and differentiation (2008) Radiology, 247, pp. 428-434
Morais, M.B., Sdepanian, V.L., Tahan, S., Goshima, S., Soares, A.C., Motta, M.E., Fagundes, N.U., Effectiveness of anorectal manometry using the balloon method to identify the inhibitory recto-anal reflex for diagnosis of Hirschsprung's disease (2005) Rev Assoc Med Bras, 51, pp. 313-317
Pseudopneumoperitoneum in chronic intestinal pseudo-obstruction: a case report
Chronic intestinal pseudo-obstruction (CIPO) is a rare disease due to a severe gastrointestinal motility disorder which may mimic, on both clinical and radiological grounds, mechanical obstruction. We report a case of a 26-year-old woman who presented to our institution for plain abdominal radiography for referred long-lasting constipation with recurrent episodes of abdominal pain and distension. At X-ray, performed both in the upright and supine position, an isolated air-fluid level was depicted in the left flank, together with a number of radiological signs suggestive of pneumoperitoneum. First, subphrenic radiolucency could be observed in the upright film. Second, the intestinal wall of some jejunal loops appeared to be outlined in the right flank. Third, the inferior cardiac border was clearly depicted in the upright film. The patient however had no evidence of peritoneal signs but only hypoactive bowel movements. Unenhanced multi-detector computed tomography (MDCT) of the abdomen and pelvis was therefore performed. MDCT revealed abnormal air-driven distension of the small and large bowel, without evidence of extra-luminal air. All radiological signs of pneumoperitoneum turned out to be false-positive results. The patient was submitted to pan-colonoscopy and to anorectal manometry to rule out Hirshprung's disease, and was finally discharged with a diagnosis of CIPO.
Pseudopneumoperitoneum in chronic intestinal pseudo-obstruction: a case report
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Pseudopneumoperitoneum in chronic intestinal pseudo-obstruction: a case report