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Investigation of Free Gas in the Peritoneal Cavity^*

This excerpt was created in the absence of an abstract.

The radiological technique for the detection of free gas in the peritoneal cavity is dependent on the situation of such gas and the condition of the patient at the time of the examination. The majority of patients examined are ill—acutely ill, either in the immediate post-operative period or have been admitted as an acute abdominal crisis. For this reason they are mostly ward cases in bed and must be disturbed as little as possible. A ward unit is used, either portable or mobile, and the positioning of the unit should be done before disturbing the patient. Most cases are already in the Fowler's position, propped up in bed, and invariably have a degree of respiratory embarrassment.

To avoid disturbing the patient, the cassette is placed behind and an antero-posterior view taken, the tube centred a little above the xyphisternum. The low centring enables us to include the lower zones of the lung and the upper abdomen on one film. The kilovoltage used is slightly more than the usual chest technique, about 75 kV, and the distance is 4 ft. In view of the small outputs of the X-ray units, ultra-rapid screens and films should be used. If the case is ambulant an examination can be made in the X-ray department by the usual techniques, always bearing in mind that free gas in the peritoneal cavity will rise to the most dependent part and is best shown beneath the diaphragm in the upright position and in the flanks in the lateral decubitus.

^* Read to members of the Faculty of Radiologists at their Annual Meeting, Leeds, June 1945.

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