الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Pneumoperitoneum is frequently considered one of the commonest surgical emergencies due to its association with gastrointestinal perforation that can result in peritonitis, septic shock, multiorgan failure and death. Accurate and Timely detection of these emergencies is of paramount importance in the management and outcome of the patients. Thus prompt diagnosis is a vital to avoid unnecessary or delayed interventions . The study aimed to provide the recent advances in detection of pneumoperitoneum using bedside ultrasound and comparing the ultrasonographic findings with the intraoperative findings. The study was carried out in the Emergency Medicine and Traumatology Department at Tanta University Hospitals in the period from September 2019 to September 2021, included 83 adult patients presented with acute abdominal pain with suspected gastrointestinal perforation and underwent surgical intervention. All patients were subjected to full assessment including history taking, physical examination, laboratory investigations. US was performed by the emergency physician and Plain radiography was done as an important diagnostic tool in acute abdominal pain. All enrolled patients underwent surgical intervention and the intraoperative findings were compared to the US and plain radiography findings. C Patients then were observed postoperative for one week to detect the complications and record the outcome. Data of the patients regarding demographic data, medical history, vital signs, laboratory investigations, disposition and outcome were collected and the results are summarized, tabulated and statistically analyzed in the following tables and figures. The main data found were that The most common age group was 40 - 60 y with predominance of males (male: female 2.7:1). chronic use of NSAID was the most important risk factors of GI perforation especially in those with history of acid peptic disease. Gastroduodenal region was the most common site of perforation. Acid peptic disease was the most common etiology. Most of patients had favorable outcome and discharged from hospital within one week after surgery. While few cases developed complications or mortality. Delay between symptoms and ED arrival played an important role in the outcome. Unfavorable outcome was more in patients who delayed presentation to ED. Also unfavorable outcome was more in patients complicated with sepsis induced hypotension and ARDS. The study showed that there is a positive correlation between the US findings and the intraoperative findings. US was more sensitive but less specific than plain radiography. US is a simple, reliable, non invasive bedside diagnostic modality of pneumoperitoneum.