PEDIATRICS Vol. 69 No. 5 May 1982, pp. 587-589
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Neonatal Pneumoperitoneum Without Significant Adventitious Pulmonary Air: Use of Metrizamide to Rule Out Perforation of the Bowel

Mervyn D. Cohen MBChB1, Richard Schreiner MD1, and James Lemons MD1

1 Departments of Radiology and Pediatrics, James Whitcomb Riley Hospital for Children, Indiana University Medical Center, Indianapolis

Pneumoperitoneum in the neonate may be due to air that has dissected from the chest. Four infants, in whom pneumoperitoneum, from thoracic air dissection, occurred in the absence of pneumothorax or pneumomediastinum are reported. The absence of abnormal collections of air in the chest is of no value in deciding whether a pneumoperitoneum is due to bowel perforation or air dissecting from the chest. Contrast bowel studies are needed in all cases of pneumoperitoneum in the infant to distinguish bowel perforation from intrathoracic origin of the air.

Submitted on April 13, 1981
Accepted on July 10, 1981