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Related Experiment Videos

Pneumoperitoneum: the misleading double wall sign

G de Lacey, T Bloomberg, B K Wignall

    Clinical Radiology
    |July 1, 1977
    PubMed
    Summary

    Seeing both sides of the gut wall on abdominal X-rays can suggest free air, a sign of pneumoperitoneum. However, this can be mimicked by adjacent, distended bowel loops, requiring careful diagnosis.

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    Area of Science:

    • Radiology
    • Gastroenterology
    • Abdominal Imaging

    Background:

    • The presence of free air in the peritoneal cavity (pneumoperitoneum) is a critical finding on plain abdominal films.
    • A classic radiographic sign suggestive of pneumoperitoneum is the visualization of both sides of the gas-filled bowel wall.

    Purpose of the Study:

    • To evaluate the reliability of the "double wall sign" in diagnosing pneumoperitoneum.
    • To highlight potential pitfalls in interpreting this radiographic sign.

    Main Methods:

    • Review of in vitro studies examining radiographic appearances.
    • Analysis of clinical cases demonstrating the "double wall sign".

    Main Results:

    • The "double wall sign" can be accurately simulated by adjacent loops of distended bowel.
    • This simulation can lead to a false-positive diagnosis of pneumoperitoneum.

    Conclusions:

    • Radiographic interpretation requires caution when encountering the "double wall sign".
    • Diagnosis of pneumoperitoneum should not solely rely on this sign; further investigation may be necessary.

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