Case contributed by Dr Andrew Dixon


Abdominal distension

Patient Data

Age: 35
Gender: Female

On the erect image a small volume of pneumoperitoneum is detected under the right hemidiaphragm. On the supine image, there is an excellent example of Rigler's sign in the left upper quadrant, again indicating pneumoperitoneum. 

Annotated image

Supine abdominal radiograph with the outer wall (serosal aspect) of a bowel loop visible in the left upper quadrant. This is an example of Rigler's sign and implies that there must be free air within the peritoneal cavity otherwise this interface would not be visible.  

Case Discussion

Typical appearance of free intraperitoneal gas (pneumoperitoneum) on erect and supine abdominal radiographs including an excellent example of Rigler's sign

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Case information

rID: 35425
Published: 22nd Apr 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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