ROENTGENOGRAPHIC DIAGNOSIS OF SMALL AMOUNTS OF INTRAPERITONEAL FLUID

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Abstract
Review of a series of cases in which increased intraperitoneal fluid was proved at surgery indicates the following roentgenographic findings demonstrable on plain roentgenograms. The smallest amounts of intraperitoneal fluid may cause the medial border of the properitoneal fat zone to be sharply defined, smoothly convex and visible extending below the iliac crest. Greater amounts of fluid in the flank, in addition, produce a narrow band of homogeneous density medial to the properitoneal fat. The fluid may also be visible as wedged-shaped densities extending medially between haustral folds or intestinal loops. The radiolucent flank stripe becomes progressively more narrow or is unilaterally narrow as a result of lateral bulging of the fluid filled peritoneal cavity. Fluid collecting in the pelvis produces a bilateral or central symmetric area of homogeneous density with a smoothly convex inferior border. This is often delimited from the bladder by a characteristic narrow zone of radiolucency not previously described. Fluid in the pelvis may be visible extending cranially between loops of intestine when gaseous distention is present.

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