1. By;
Mr. Adeel ABBAS

2. Normal Chest X-Ray

3. Enhanced CXR

4. Is Gas Under Diaphragm Abnormal?

5. Gas Under Diaphragm Is Not Always Dangerous
Because It Can Physiologically Be The Gas …
 In Fundus Of The Stomach Or
In Large Intestine…

6. Is The Gas Under Diaphragm Dangerous?

7. The Gas Itself Isn't Dangerous, But The Fact That
Enteric Content Is Leaking Out Along With It Is
Deadly…

9. Gas in Fundus of Stomach…

11. Gas in the Fundus of Stomach…

13. Gas Under Both
Domes of
Diaphragm.
Gas in Large
Intestine.
Gas in Fundus of
Stomach.

14. What are the Causes ?????

15. 1. Perforation of Intestine.
What are the Causes ?????
2. Gas Forming Organism.
3. Iatrogenic.
4. Pervaginum.
5. Interposition of Bowel Between Liver & Diaghram.

16. 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.

19. Hair –Line Gas Under
the Right Dome of
Diaphragm.

24. Gas in Hepatic Flexure
Under the Right Dome
of Diaphragm.

25. Management ?

26. Principles of Management;
Resuscitation.
Decontamination of Peritoneal Cavity.
Repair of Perforation OR Diversion.

27. Gas in Fundus of Stomach in Dextro-Cardia

28. Hair –Line Gas Under
the Left Dome of
Diaphragm in Dextro-
Cardia.