When Free Air Means Emergency: Imaging Diagnosis of Pneumoperitoneum in Glioblastoma Patients
Introduction When a Single Line of Air Determines Life or Death The emergency department is filled with countless patients presenting with abdominal pain, distension, nausea, and vague discomfort. Most ultimately prove to have benign, self-limited conditions. Yet among these seemingly routine presentations lies one radiologic finding that instantly changes the course of clinical care: pneumoperitoneum . For radiologists and emergency physicians, the detection of free intraperitoneal air represents one of the most critical imaging diagnoses in medicine. A subtle crescent of gas beneath the diaphragm on an upright chest radiograph may be the only early clue to catastrophic gastrointestinal perforation. Failure to recognize this sign can delay surgical intervention, leading to overwhelming sepsis, multiorgan failure, and death. The presented case exemplifies this diagnostic challenge. A 70-year-old woman with advanced glioblastoma multiforme arrived at the emergency department after...
