March 1956, Vol 72, No. 3 >

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ARTICLE | March 1956

The Roentgenogram in Perforated Peptic Ulcer

LAWRENCE S. MANN, M.S., M.D.; ISRAEL E. KIRSH, M.D.; JESSE EISEN, M.D.; JOHN E. FAMILARO, M.D.

AMA Arch Surg. 1956;72(3):450-455. doi:10.1001/archsurg.1956.01270210080013.

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Surgeons have realized the value of the roentgenographic examinations as an aid in the diagnosis of perforated peptic ulcer for some time. We have been able to demonstrate that a multiple position technique significantly increases the diagnostic accuracy, as compared with a single film taken in the upright position, which is frequently all that is made.

Popper¹ advocated the upright position as early as 1915 to demonstrate free air in the abdominal cavity. According to Cole and Berne² the accepted diagnostic accuracy of the x-ray examination in perforated peptic ulcer is between 75% and 80%. Kornblum³ reported the incidence of pneumoperitoneum in 87 cases of perforations of the gastrointestinal tract. The free air was demonstrated in 59.3% of the stomach perforations and 70.4% of the duodenal perforations. Vaughn and Brams⁴ utilized either the upright or the lateral decubitus position and obtained an accuracy of more than

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MANN LS, KIRSH IE, EISEN J, FAMILARO JE. The Roentgenogram in Perforated Peptic Ulcer. AMA Arch Surg. 1956;72(3):450-455. doi:10.1001/archsurg.1956.01270210080013.

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