Ultrasound versus Plain Radiography in the Detection of Pneumoperitoneum

Abstract

Abstract:Objective: To compare plain radiography with ultrasonography in the detection of pneumoperitoneum.Methods: A total of 72 patients with suspected hollow viscus perforation were studied. All patients had ultrasonography, upright chest radiography and left lateral decubitus abdominal radiography examination. The sensitivity, specificity, positive and negative predictive value, and accuracy of upright chest and abdominal radiography were compared with that of abdominal ultrasonography.Results: Sixty eight patients underwent laparotomy; 66 patients had hollow viscus perforations, (if we include four patients had perforated appendicitis) and two had acute cholecystitis. In the diagnosis of pneumoperitoneum, ultrasonography had improved sensitivity (90 versus 75 percent), negative predictive value (36 versus 18 percent), and accuracy (88 versus 74 percent), and similar specificity (both 50 percent), and positive predictive value (95 versus 93 percent) compared with plain radiography.Conclusion: Ultrasonography is more sensitive than plain radiography in the diagnosis of pneumoperitoneum.Key words: Ultrasonography, Radiography, Pneumoperitoneum.