Gas Under Diaphragm - Final Year MB BS Lecture

By;Mr. Adeel ABBAS

Normal Chest X-Ray

Enhanced CXR

Is Gas Under Diaphragm Abnormal?

Gas Under Diaphragm Is Not Always

Dangerous Because It Can Physiologically Be

The Gas …

In Fundus Of The Stomach Or

In Large Intestine…

Is The Gas Under Diaphragm Dangerous?

The Gas Itself Isn't Dangerous, But The Fact

That Enteric Content Is Leaking Out Along

With It Is Deadly…

Gas in Fundus of Stomach…

Gas in the Fundus of Stomach…

Gas Under Both Domes of Diaphragm.

Gas in Large Intestine.

Gas in Fundus of Stomach.

What are the Causes ?????

1. Perforation of Intestine.

What are the Causes ?????

2. Gas Forming Organism.

3. Iatrogenic.

4. Pervaginum.

5. Interposition of Bowel Between Liver & Diaghram.

Free Air Can Only Get To The Point Of Being

"Under The Diaphragm" On An Upright X-ray

(Chest X-ray P.A).

If You Do A Ct Scan On A Patient Who Is Lying

Down, The Air Will Go To The Highest Point Which

Is Under The Umbilicus.

The Detection Of Free Air Is Best Done With An

Chest X-ray Series.

Hair –Line Gas

Under the Right

Dome of Diaphragm.

Gas in Hepatic

Flexure Under the

Right Dome of

Diaphragm.

Management ?

Principles of Management;

Resuscitation.

Decontamination of Peritoneal Cavity.

Repair of Perforation OR Diversion.

Gas in Fundus of Stomach in Dextro-Cardia

Hair –Line Gas

Under the Left Dome

of Diaphragm in

Dextro-Cardia.