Abdominal x-ray review: air

Last revised by Dr Jeremy Jones on 14 Aug 2021

Abdominal x-ray review is a key competency for medical students, junior doctors and other allied health professionals. Using ABDO X is a helpful and systematic method for abdominal x-ray review, where A refers to the assessment of the presence and location of air.


  • introduction
    • air should only be within bowel loops
    • free peritoneal air is known as pneumoperitoneum
    • erect chest x-rays are more sensitive to the presence of pneumoperitoneum than abdominal x-rays
    • however, there are some key signs on abdominal x-rays of a pneumoperitoneum
  • procedure

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Cases and figures

  • Figure 1: Rigler sign of free intraperitoneal gas
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