Football sign

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Neonate distended abdomen.

Patient Data

Age: <1
Gender: Male
x-ray

The football sign observed in large pneumoperitoneum in neonates, extending over the whole abdomen.

Case Discussion

This newborn developed a large pneumoperitoneum after a few days of life, as a complication of necrotizing enterocolitis.  The appearances are described as the football sign giving the elliptoid shape in the craniocaudal direction.  It must be highlighted this is an 'American' football its shape represents, rather than the one used in the European game of football (soccer in America). 

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