Image Based Question-67284

A patient presented with acute, severe abdominal pain.Abdominal guarding was present on examination.History of smoking, high alcohol intake, and long term use of non-steroidal anti-inflammatory drugs was present.

Chest X ray showed the following features.What can be the most probable diagnosis?

A. Pneumoperitoneum.

B. Pneumomediastinum.

C. Pleural Effusion.

D. Normal.

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Correct Answer » A Explanation

Ans:A. Pneumoperitoneum.

Chest X ray in the image shows:

• The lungs are normal

• The diaphragm is crisply defined on both sides .

• Air under the diaphragm is seen as crescents of relatively low density .

Diagnosis: Pneumoperitoneum possible due to a perforated duodenal ulcer