Presentation
3 days of abdominal distension, hemodynamic instability and a dusky abdomen. Preterm - 24/40.
Patient Data
Age: 4 days old
Gender: Female
From the case:
Rigler sign - neonate
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Frontal view of the abdomen demonstrates dilated loops of bowel. A lucency in the right upper quadrant and gas on both sides of the bowel wall consistent with pneumoperitoneum.
Case Discussion
An emergent bedside mini laparotomy was performed which confirmed the diagnosis of bowel perforation in a very premature neonate. This patient was also intubated since birth, required aggressive ventilatory support, was on pressors for hemodynamic support and broad spectrum antibiotics.
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