Abstract—In developing world where limited availability of resources and over burden of patient imposing a limitation in adapting advanced radiological technique as a first line of investigation, plain radiography may be considered as a valuable screening tool in detecting pneumoperitoneum if it’s effectively is acceptable. A validational type of observational study was conducted on 1723 patients of perforation peritonitis confirmed by laprotomy to find out the effectiveness of plain radiography in diagnosing hollow viscous perforation. All these patients were advised an upright chest and erect abdominal radiograph before going to surgery. Gas under Diaphragm (GUD) was seen and compared the findings of laprotomy to find out effectiveness of the plain radiography in diagnosing hallow viscous perforation. Positivity Rate of plain radiography either upright chest X-ray or erect abdomen in detecting pneumoperitoneum is 89.20%. So in developing world with limited resources plain radiography may be be adopted as screening tool in detecting pneumoperitoneum
Key words: Diagnostic Effectiveness, Gas under Diaphragm (GUD), Laprotomy, Peritonitis, Pneumoperitonium
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