PEARLS ascites

Sonographic detection of pneumoperitoneum:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159171/

The presence of air in abnormal locations scatters the ultrasound waves at the interface of soft tissue and air resulting in an enhanced peritoneal stripe sign, ring-down artefacts and acoustic shadows resembling “comet tails”.

The shifting phenomenon of movement of free intraabdominal air with patient position changes is strong sonographic evidence to support the presence of free air in the abdomen.

A linear array transducer (10–12 MHz) would be preferable over the standard curvilinear probe (2–5 MHz) owing to its superior near-field resolution.

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