<prompt> In which of the following conditions is air under both sides of diaphragm visualized -Perforated Meckels diveiculumUterine rupture following illegal aboionPerforation of duodenal ulcerAll  <response>: Answer is a i.e. Perforated Meckels diveiculum; b i.e. Uterine rupture following illegal aboion; c i.e. Perforation of duodenal ulcer Gas under left hemidiaphragm is due to fundal gas, a normal finding. When gas is present under right hemidiaphragm also its due to pneumoperitoneum. Causes of Pneumoperitoneum 1 Perforation of GI tract Peptic ulcer Inflamamtion diveiculitis, appendicitis, toxic megacolon, necrotizing enterocolitis Infarction Malignant neoplasm Obstruction Pneumatosis cystoides rupture - Iatrogenic-endoscopy 2 Iatrogenic - Surgery, peritoneal dialysis, drainage catheters, biopsies 3 Penetrating abdominal injury. 4 Through female genital tract a Spontaneous b latrogenic - iatrogenic perforation of uterus or vagina culdocentesis - tubal patency test 5 Gas forming peritonitis 6 Pneumothorax with pleuroperitoneal fistula 