- Etiology: placement of a gastrojejunostomy tube, use of indomethacin to close a patent ductus arteriosus, bowel atresia, ischemic necrosis, blunt trauma
- CXR upright: air beneath the diaphragm
- AXR upright: air beneath the diaphragm
- AXR left lateral decubitus: air above the liver (air between abdominal wall and liver)
- AXR cross-table lateral: for small amounts of free air see tell-tale triangle sign of air between bowel loops, for large amounts of free air see air superiorly between abdominal wall and viscera
- AXR supine: overall increased lucency of abdomen, American football sign of falciform ligament, inverted Y of umbilical artery ligaments, Rigler’s sign (see air outlining both sides of bowel wall)
- Note:
— Neonates with bowel perforation have an inflamed abdomen and pneumoperitoneum may be loculated and not be classically seen on upright / decubitus / cross-table lateral views and pneumoperitoneum may appear as fixed air collection that does not appear to conform to bowel
— In such cases, US showing complex free fluid may assist in making the diagnosis of bowel perforation, keeping in mind the differential diagnosis of complex free fluid is bowel perforation / infection / hemorrhage
Radiology Cases of Small Bowel Perforation




Surgery Cases of Small Bowel Perforation

