THE FREQUENCY OF AIR UNDER THE DIAPHRAGM IN PERFORATED GASTRIC AND DUODENAL ULCER

Abstract

Roentgenographic demonstration of air under the diaphragm in cases of perforated peptic ulcer has been reported by many authors and is mentioned briefly in all modern textbooks on roentgen interpretation. All authors agree that demonstration of spontaneous pneumoperitoneum is pathognomonic of perforation, but the reader is left in considerable doubt as to the frequency with which air can be demonstrated in such cases. Since the finding of air is pathognomonic, the value of this sign depends on the percentage of cases in which the sign can be elicited. With the idea of getting more definite information on this question, I have examined the charts of all patients admitted to the Louisville City Hospital during the past five years who have had an admission diagnosis of perforated peptic ulcer, seventy-six cases in all. Thirty cases must be eliminated because there was no x-ray examination. The remaining forty-six