ABSTRACT
To determine the frequency of duodenal ulcer perforation with radiological evidence of gas under the diaphragm on X-ray chest. Descriptive. Department of Surgery Combined Military Hospital [CMH] and Military Hospital [MH], Rawalpindi, from Nov, 2005 to May 2006. Patients with acute abdomen presenting as emergency at CMH and MH Rawalpindi were evaluated. Preoperatively X-ray chest PA view, in standing posture, was done in all cases and presence or absence of pneumoperitoneum noted. The patients were then followed by laparotomy to confirm or otherwise a perforation of duodenum. Only 30 patients were included in the study where duodenal perforation was confirmed per-operatively. Pneumoperitoneum on X ray chest PA view was found in 25 [83.3%] out of 30 patients with duodenal ulcer perforation; The remaining 05 patients i.e. 16.67% did not show pneumoperitoneum. X-ray chest is a helpful tool in diagnosing majority of patients with a perforated duodenal ulcer. However there is a significant number of patients where the clinical acumen of the doctor would help in an early diagnosis and prompt treatment