Rigler sign (bowel)

Dr Craig Hacking and Dr Jeremy Jones et al.

The Rigler sign, also known as the double wall sign, is seen on a radiograph of the abdomen when the air is present on both sides of the intestine, i.e. when there is air on both the luminal and peritoneal side of the bowel wall.

Pneumoperitoneum may be a result of perforation or, recent instrumentation or surgery. A false double wall sign can result from two loops of bowel being in contact with one another.

Practical points

Rigler sign should not be confused with the Rigler triad, the Rigler notch sign, or Hoffman-Rigler sign

History and etymology

It is named after Leo George Rigler (1896-1979), American radiologist 2.

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Article information

rID: 4849
Section: Signs
Synonyms or Alternate Spellings:
  • Rigler's sign

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Cases and figures

  • Rigler's sign

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    Case 1: annotated
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  • Case 2
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  • Case 3
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  • Case 8: perforated Crohn disease of small bowel
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  • Case 9: small bowel infarction
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  • Case 10: on CXR
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  • Case 11
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  • Case 12
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