Cupola sign

Cupola Sign is a medical term used in radiology to describe a specific appearance on a chest X-ray or CT scan. It is often associated with Pneumoperitoneum, a condition where air or gas is present in the abdominal cavity. The Cupola Sign is considered a reliable indicator of this condition.

Definition

The Cupola Sign is defined as the presence of free air under the central tendon of the diaphragm, which is visualized as a radiolucent shadow over the cardiac silhouette on an erect chest X-ray. This sign is named after the Italian word 'cupola', which means 'dome', due to the dome-shaped appearance of the air under the diaphragm.

Clinical Significance

The Cupola Sign is a significant clinical finding as it is often indicative of Pneumoperitoneum. Pneumoperitoneum is a serious medical condition that requires immediate attention. It is most commonly caused by perforation of a hollow viscus, such as the stomach or intestines, but can also be caused by other conditions such as Pneumothorax or Pneumomediastinum.

Diagnosis

The diagnosis of the Cupola Sign is typically made through imaging studies. An erect chest X-ray is the most common method used to identify this sign. However, a CT scan can also be used for diagnosis, and is often more sensitive in detecting small amounts of free air.

Treatment

The treatment for conditions associated with the Cupola Sign, such as Pneumoperitoneum, typically involves surgery to repair the perforated viscus. In some cases, non-surgical treatments may be used, such as antibiotics or observation, depending on the cause and severity of the condition.

See Also

• Pneumoperitoneum
• Pneumothorax
• Pneumomediastinum

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