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Why must the diaphragm be visualized in an acute abdominal series?

  1. To detect any possible tumors in the diaphragm area.

  2. To ensure that the entire abdominal area is included in the image.

  3. To identify the presence of free air indicating pneumoperitoneum.

  4. To confirm proper positioning of the patient during the exam.

The correct answer is: To identify the presence of free air indicating pneumoperitoneum.

The visualization of the diaphragm in an acute abdominal series is crucial because it allows for the identification of free air in the abdominal cavity, which can indicate the presence of pneumoperitoneum. Free air typically accumulates under the diaphragm due to a perforation in an abdominal organ, such as the stomach or intestines. The presence of free air is a critical finding that may necessitate immediate surgical intervention to address any potential complications. In acute abdominal series imaging, the upright or left lateral decubitus positions are particularly effective for revealing free air, as it will rise to the highest point within the abdominal cavity, which is often underneath the diaphragm. Therefore, confirming the presence or absence of free air is a vital part of the assessment in patients presenting with acute abdominal pain, making the visualization of the diaphragm an essential component of the imaging protocol.