• Is the presence of free air within the abdomen.
  • The best radiograph view to detect pneumoperitoneum is erect chest film. It appears as crescentic area of lucency under diaphragm.
  • Lateral decubitus can be used for very ill patient. (! Right/ Left).
  • Free air can be best evaluated with CT scan of the abdomen
  • can also be found normally in female

Causes:

  • Peptic ulcer perforation.
  • Post laparotomy/ laparoscopy.
  • Colonic diverticulum perforation.

Free gas in the peritoneal cavity:

On this chest radiographs, air can be seen under the domes of both hemidiaphragms.