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A combined occurrence of massive retropneumoperitoneum and pneumoperitoneum is rare.
Two recent cases are reported: one resulting from an iatrogenic perforation of the sigmoid; and the other from an inadvertent introduction of air into the retroperitoneal space.
The anatomic relationships, directions of spread, and the roentgen manifestations of a combined occurrence of retropneumoperitoneum and pneumoperitoneum are discussed.
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