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Department of Public Health
P. 0. Box 229
Columbus, Georgia
September 30, 1948
Dr. Mark F. Boyd, Editor
American Journal of Tropical Medicine
615 East Sixth Avenue
Tallahassee, Florida
Drs. Clark, Bercovitz and Jones are to be congratulated on their suggestion that pneumoperitoneum be used to demonstrate amebic abscesses of the liver. (Pneumoperitoneum in the Diagnosis of Amebic Liver Abscess, Am. J. Trop. Med., 28: 545, July, 1948.
However, their technic of initiating pneumoperitoneum seems somewhat dangerous. The site of election for the needle puncture varies greatlypersonally I feel that a site near enough to the costal margin to allow the operator to steady his hand against the ribs offers a considerable advantage. But to allow the air to flow through the needle during the puncture of the peritoneum would seem quite hazardous. Pneuinoperitoneum is a relatively safe procedure. Puncture of a hollow viscus is rarely accomplished, unless there are adhesions at the site of injection, in which event it does not seem that allowing the air to flow through the needle would avoid this complication.
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