Dirty Mass sign of abdominal imaging: A case of silent pneumoperitoneum

Garrett Coleman, Hasan Khan, Anthony D'Angelo, Zahra Aktar, Irfan Masood

Research output: Contribution to journalArticlepeer-review


Pneumoperitoneum is a common complication after penetrating abdominal trauma, gastric ulcer, or colitis in which free air is present in the peritoneal or retroperitoneal space. Sole pneumoretroperitoneum, which refers to gas in the retroperitoneal space, is a rare entity, and when significant, results in a characteristic radiographic sign known as “Dirty Mass.” Common causes include penetrating trauma or perforation of the retroperitoneal portions of the gastrointestinal tract (duodenum, ascending colon, descending colon, and rectum). Our case describes a 59-year-old female admitted for sudden onset RLQ abdominal pain with Dirty Mass sign on abdominal KUB. Early recognition of these key radiographic findings accelerates management and reduces the risk of developing complications.

Original languageEnglish (US)
Pages (from-to)1839-1842
Number of pages4
JournalRadiology Case Reports
Issue number5
StatePublished - May 2024
Externally publishedYes


  • Colonic perforation
  • Dirty Mass
  • Dirty Mass sign
  • Pneumoretroperitoneum
  • Retroperitoneum

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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