Iatrogenic causes like endoscopic perforation may also give football sign.The Cupola sign is seen when air is accumulated under the central tendon of the diaphragm. Differential diagnosis
As differential diagnoses, a subphrenic abscess, bowel interposed between diaphragm and liver (Chilaiditi syndrome), and linear atelectasis at the base of the lungs can simulate free air under the diaphragm on a chest X-ray. Treatment
Treatment depends on the cause of the condition. Terminology
Pneumoperitoneum can be described as peritoneal emphysema, just as pneumomediastinum can be called mediastinal emphysema, but pneumoperitoneum is the usual name. See also
Cupola sign
Football sign
Pneumoretroperitoneum
Riglers sign

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Because of obstruction, subsequent local inflammation of the area leads to dilation of the lymph vessels and the development of a urinary fistulae due to rupture of the lymphatic vessel, which allows for the passage of white blood cells, fat, and fat-soluble vitamins into the urine.Another cause of chyluria is pregnancy or childbirth.In the United States, one of the most common causes is partial nephrectomy or thermal ablation of a kidney lesion. Treatment
Following a low fat and high fluid diet is recommend for managing symptoms.Medicines that inhibit cholesterol absorption in the small intestine, such as Ezetimibe, may be effective treatments in some patients.An anti-filarial drug, such as diethylcarbamazine, may be prescribed. Severe damage to lymph channels may require surgery. Sclerotherapy with instillation of 1%  of silver nitrate or povidone iodine (2ml of 5% + 8ml distilled water). References


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