Question

2 X-rays (Erect & Supine) were given to identify the condition

• A. Empyema Thorax
• B. Liver abscess
• C. Liver abscess
• D. Hollow viscus perforation

Answer 1

The Correct Option is D

To determine the correct diagnosis from the given X-rays (erect and supine), we need to assess the specific features that each condition can exhibit on such imaging. Here's a step-by-step explanation:

1. Empyema Thorax: This condition involves the accumulation of pus in the pleural cavity. On an X-ray, you may observe pleural fluid collection and possible loculated fluid, but typically, an erect abdominal X-ray is not the primary tool for its diagnosis.
2. Liver Abscess: An abscess in the liver would primarily be suggested by the presence of an abnormal mass in the liver region, often better visualized with ultrasound or CT rather than plain X-ray.
3. Hollow Viscus Perforation: This condition involves the perforation of an organ such as the stomach or intestines, leading to the escape of air into the peritoneal cavity. On an erect X-ray, this is most commonly identified by free air under the diaphragm (pneumoperitoneum), an essential diagnostic feature visible in a standing position. A supine X-ray might show air outlining the abdominal cavity or a 'football sign'.

Considering the clinical setting and the specific benefit of using both erect and supine X-rays to detect free air, the finding of a pneumoperitoneum is most consistent with a Hollow viscus perforation. Hence, this is the correct diagnosis based on the provided images.