No free air under diaphragms?

Discussion in 'Medical Students - MD' started by alicelinden, May 6, 2002.

  1. alicelinden

    alicelinden Junior Member

    Joined:
    Dec 1, 2001
    Messages:
    11
    Likes Received:
    0
    On CXR, what is no free air under the diaphragms a sign of?

    I'm guessing one possibility is that the bowels are in the way... but is there a "classic" answer to this description?
     
  2. Thread continues after this sponsor message. SDN Members do not see this ad.

  3. intern in waiting

    intern in waiting Junior Member

    Joined:
    Apr 28, 2002
    Messages:
    20
    Likes Received:
    0
    no free air under the diaphragm is a normal finding, free air under the diaphragm is a sign of a ruptured abdominal organ (usually)
     
  4. doughboy

    doughboy Senior Member

    Joined:
    Jul 16, 2001
    Messages:
    253
    Likes Received:
    0
    Just like the previous poster said, there should never be free air under the diaphragm in normal people. You check for free air under the diaphragm in patients whom you suspect a bowel perforation.
     
  5. Mr. happy clown guy

    Mr. happy clown guy Senior Member

    Joined:
    Jul 30, 2001
    Messages:
    236
    Likes Received:
    0
    Think of it this way..."free air" is "extra luminal air"...suggesting there is a luminal rupture.
    Thus, "no free air" is a normal and expected finding.
     
  6. jdaasbo

    jdaasbo Senior Member

    Joined:
    Jan 7, 1999
    Messages:
    296
    Likes Received:
    1
    simply it indicates pneumoperitoneum. This is a normal finding post laparoscopic abdominal procedures (during which you have iatrogenic pneumoperitoneum).

    Otherwise it may indicate (as others have suggested) a perforated viscus.
     
  7. Mr. H

    Joined:
    Dec 11, 2001
    Messages:
    652
    Likes Received:
    0
    wow, you guys are so cool! I hope I'll be able to do that sh** in a couple years!
    peace
     
  8. Chris_P

    Chris_P Senior Member

    Joined:
    Apr 28, 2002
    Messages:
    119
    Likes Received:
    0
    Sign of recent waterskiing <img border="0" title="" alt="[Wink]" src="wink.gif" /> (but only for girls!)

    Chris
    <a href="http://www.dissectionroom.com" target="_blank">www.dissectionroom.com</a>
     
  9. Starflyr

    Starflyr Manic Faerie

    Joined:
    Apr 11, 2000
    Messages:
    745
    Likes Received:
    0
    No *free* air is normal, but air in the fundus of the stomach is...dont know if that may be what the instructor *meant*?

    Star
     
  10. acurarte

    acurarte Member

    Joined:
    Mar 5, 2002
    Messages:
    67
    Likes Received:
    0
    Waterskiing... Good one!!!! You would get an honor grade if I was your attending!
     
  11. LaCirujana

    LaCirujana Smoking Gun

    Joined:
    Feb 23, 2002
    Messages:
    899
    Likes Received:
    1
    "Sign of recent waterkiing <img border="0" title="" alt="[Wink]" src="wink.gif" /> (but only for girls!)"

    Uh, wouldn't that be "free fluid" in the abdomen? (It was the last time I got pimped on it. :) )
     
  12. Chris_P

    Chris_P Senior Member

    Joined:
    Apr 28, 2002
    Messages:
    119
    Likes Received:
    0
    If water was getting in you'd be quite likely to get air in too (pushed in by the water perhaps) but the point is that you wouldn't see the water on Xray but the air would make its way to the top and sit under the diaphragm.

    Chris
    ----------------------
    <a href="http://www.dissectionroom.com" target="_blank">www.dissectionroom.com</a>
     
  13. LaCirujana

    LaCirujana Smoking Gun

    Joined:
    Feb 23, 2002
    Messages:
    899
    Likes Received:
    1
    Sorry--thinking CT. You're absolutely correct.
     
  14. droliver

    Moderator Emeritus

    Joined:
    May 1, 2001
    Messages:
    1,555
    Likes Received:
    72
    Status:
    Attending Physician
    yeah, that waterskining factoid is one of those classic zebra factoids that you'll get pimped about. I dare say that in reality most people would still be uncomfortable attributing free-air after a water-skining accident to this phenomena & would assume there was a perforated viscus instead
     

Share This Page