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The cupola sign is seen on a supine chest or abdominal radiograph in the presence of pneumoperitoneum. It refers to dependent air that rises within the abdominal cavity of the supine patient to accumulate underneath the central tendon of the diaphragm in the midline. It is seen as lucency overlying the lower thoracic vertebral bodies.
Pneumoperitoneum is pneumatosis (abnormal presence of air or other gas) in the peritoneal cavity, a potential space within the abdominal cavity.The most common cause is a perforated abdominal organ, generally from a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma.
The sign can be permanently present, or sporadically. This anatomical variant is sometimes mistaken for the more serious condition of having air under the diaphragm ( pneumoperitoneum ) which is usually an indication of bowel perforation , possibly leading to surgical interventions.
Blade of grass sign (also known as Flame sign) Blumensaat's line; Bohler's angle; Bone-within-a-bone appearance; Boomerang sign; Bow tie appearance; Bowl of grapes sign; Bowler hat sign; Brim sign; Bucket handle tear; Bulging fissure sign; Bunches of grapes sign (hepatic abscess) Bunch of grapes sign (botryoid rhabdomyosarcoma) Bunch of grapes ...
Low magnification micrograph of pneumatosis intestinalis in bowel wall.. Pneumoperitoneum (or peritoneal emphysema), air or gas in the abdominal cavity.The most common cause is a perforated abdominal viscus, generally a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma.
In a series of 73 patients, plain abdominal radiography (56%) showing colic distension in 53% or a pneumoperitoneum in 3%. [12] CT scans are often used in the evaluation of abdominal pain and rectal bleeding, and may suggest the diagnosis of ischemic colitis, pick up complications, or suggest an alternate diagnosis. [26] [27] [28]
The pathogenesis of pneumatosis intestinalis is poorly understood and is likely multifactorial. PI itself is not a disease, but rather a clinical sign. In some cases, PI is an incidental finding, whereas in others, it portends a life-threatening intra-abdominal condition. [citation needed]
The dark areas on both sides of the intestines indicate that air is present in both sides. This is called "Rigler's sign". A radiologic sign is an objective indication of some medical fact (that is, a medical sign) that is detected by a physician during radiologic examination with medical imaging [1] (for example, via an X-ray, CT scan, MRI scan, or sonographic scan).