Veiled right kidney sign

The veiled right kidney sign is a sonographic sign described in pneumoretroperitoneum, most commonly due to duodenal perforation.

It refers to the appearance of the right kidney on transabdominal ultrasound ^1-4. On ultrasound, there is difficulty in obtaining images of the right kidney due to increased surrounding echogenicity, and when the right kidney is visualized there is prominent ring down artifact noticed ^1-4. This gives the appearance of a 'veil' over the right kidney due to large amounts of free retroperitoneal gas ^1-4.

Presence of such large pneumoretroperitoneum can be confirmed with abdominal cross-sectional imaging (most commonly, CT) or even plain abdominal radiograph ^2,3. Some authors also employ the description 'veiled right kidney sign' when describing the appearance of the right kidney on these non-sonographic imaging modalities as well ^2,3.

History and etymology

The sign was first described by R G McWilliams, an English radiologist, and his colleagues in 1996 ¹.