Virtual Pediatric Hospital(tm) : A digital library of pediatric information

Home | About | FAQ | Reviews | Search

Virtual Pediatric Hospital: Paediapaedia: Pneumoperitoneum Paediapaedia: Gastrointestinal Diseases


Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Clinical Presentation:
Not applicable

Causes include post laparotomy, dissection of air from a pneumomediastinum into the peritoneum, or rupture of a hollow viscus. The most common organ to perforate in a newborn (aside from perforations caused by necrotizing enterocolitis) is spontaneous perforation of the stomach. In older children the most common causes of pneumoperitoneum are a perforated peptic ulcer or Meckel diverticulum.

Not applicable

Imaging Findings:
Best seen on an upright, left lateral decubitus, or cross table lateral view of the abdomen. Signs of pneumopertioneum include:

Football sign - the falciform ligament is surrounded by air and is visible as the "laces" of the football.

Rigler's sign - gas is seen on both sides of the bowel wall.

Telltale triangle - free air accumulating in between two loops of bowel and the abdominal wall

Gas outlining the urachus or folds of the umbilical arteries.

Gas outlining the liver, spleen or gallbladder.

Diffuse lucency of the abdomen on a supine film.


See References Chapter.

Section Top | Title Page

Additional pediatric resources: | Facebook iconTwitter iconRSS icon |

Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon and Facebook @pedsimagingFacebook icon and Instagram @pedsimagingInstagram icon

About Us | FAQ | Reviews | Contact Us | Search

Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M.D. and by Michael P. D'Alessandro, M.D.

Please send us comments by filling out our Comment Form.

All contents copyright © 1992-2016 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.

"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.

Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.

Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.

The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.