Archives of Academic Emergency Medicine

Vol. 4 No. 2 (2016)

Ultrasound and Perforated Viscus; Dirty Fluid, Dirty Shadows, and Peritoneal Enhancement

Archives of Academic Emergency Medicine, Vol. 4 No. 2 (2016), 1 May 2016 , Page 101-105
https://doi.org/10.22037/aaem.v4i2.229

Abstract

Early detection of free air in the peritoneal cavity is vital in diagnosis of life-threatening emergencies, and can play a significant role in expediting treatment. We present a series of cases in which bedside ultrasound (US) in the emergency department accurately identified evidence of free intra-peritoneal air and echogenic (dirty) free fluid consistent with a surgical final diagnosis of a perforated hollow viscus. In all patients with suspected perforated viscus, clinicians were able to accurately identify the signs of pneumoperitoneum including enhanced peritoneal stripe sign (EPSS), peritoneal stripe reverberations, and focal air collections associated with dirty shadowing or distal multiple reflections as ring down artifacts. In all cases, hollow viscus perforation was confirmed surgically. It seems that, performing US in patients with suspected perforated viscus can accurately identify presence of intra-peritoneal echogenic or “dirty†free fluid as well as evidence of free air, and may expedite patient management.
Keywords:
  • Ultrasonography
  • Abdomen
  • Acute
  • Pneumoperitoneum
  • Emergency Department

How to Cite

1.
Shokoohi H, Boniface KS, Abell BM, Pourmand A, Salimian M. Ultrasound and Perforated Viscus; Dirty Fluid, Dirty Shadows, and Peritoneal Enhancement. Arch Acad Emerg Med [Internet]. 2015 Dec. 4 [cited 2026 Jul. 28];4(2):101-5. Available from: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/229

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