Presentation
Excessive crying and abdominal distension.
Patient Data
Age: 6 months
Gender: Male
From the case:
Pneumoperitoneum
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Massive pneumoperitoneum is evident by the excessive free gas in the abdominal cavity, including the bilateral subphrenic spaces and surrounding the edges of the liver (hepatic edge sign). Bowel double wall sign (or Rigler sign) is well-demonstrated.
Some of the bowel loops are significantly dilated. Gas-fluid levels are seen in the dilated lower abdominal loops. No rectal gas is seen.
Case Discussion
The features are most likely due to intestinal obstruction with bowel perforation.