Pseudopneumoperitoneum in Plain Radiograph: a Case of Pyogenic Liver Abscess

Right upper abdomen is radiopaque in plain radiographs. Radiolucency in this region separating diaphragm from the liver indicates pneumoperitoneum. Without free gas, if this finding is seen, then it is called pseudopneumoperitoneum. It has been described in relation to Chilaiditi syndrome and few other rare clinical scenarios. Theoretically speaking, a gas-containing pyogenic liver abscess can produce a similar radiographic picture. However, this is rarely seen and therefore this finding is of academic importance.