Chandler J G, Berk R N, Golden G T
Surg Gynecol Obstet. 1977 Feb;144(2):163-74.
Misleading pneumoperitoneum takes one of two forms: true pneymoperitoneum without peritonitis or pneumoperitoneum simulated by adventitious x-ray shadows. In both instances, the roentgenographic appearance of free intraperitoneal air proves to be a specious indication for laparotomy. Twenty-eight per cent of 29 patients with misleading pneumoperitoneum were subjected to operations that, retrospectively, might not seem absolutely necessary. The decisions to operate on patients with pneumoperitoneum without peritonitis were based on the amount of pneumoperitoneum roentgenographically visualized. The instances of pseudopneumoperitoneum had several common features. The diagnosis often was based only on x-ray films of the chest. Compatibility with clinical features was marginal; the radiolucency was often not truly at the apex of the diaphragm. Finally, the x-ray films, interpretation and working conditions frequently were suboptimal.
无腹膜炎的真性气腹或由偶然的X线阴影模拟的气腹。在这两种情况下，腹腔内游离气体的X线表现被证明是剖腹手术的虚假指征。29例误导性气腹患者中有28%接受了手术，回顾来看，这些手术似乎并非绝对必要。对无腹膜炎的气腹患者进行手术的决定是基于X线显示的气腹量。假性气腹的病例有几个共同特征。诊断往往仅基于胸部X线片。与临床特征的相符性很勉强；透亮区往往并非真正位于膈顶。最后，X线片、解读及工作条件常常并不理想。
