Abstract

The detection of free air under the diaphragma is the most important laboratuary finding of a perforated intraabdominal viscera. Due to the mediastinal emphysemas, subdiaphragmatic air can occur with the movement of air from mediastinum to retroperitoneum and from there through intestinal mesentery to intraperitoneal area. Therefore especially in paralyzed and sedatized patients the free air under the diaphragma should be distinguished from the abdominal surgical conditions. Here two cases are presented in which free air has been detected under diaphragma as a result of mediastinal emphysema.