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Pneumoperitoneum refers to gas in the peritoneal cavity outside of the hollow viscera. In over 90% of the cases, it arises from a bowel perforation. On an upright chest x-ray, the free air usually rises to the highest point, which is above the liver below the right hemidiaphragm. When free air is observed on a radiograph, surgery should be consulted immediately. In most cases, the patient should not have any additional imaging and go straight to the operating room. #EmergencyMedicine #rrt #respi
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