Presentation
Acute abdominal pain in an ICU patient.
Patient Data
Gender: Male
From the case:
Small bowel obstruction with perforation
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Info

Dilated bowel loops consistent with bowel obstruction.
Rigler's sign and football sign are compatible with associated pneumoperitoneum.
From the case:
Small bowel obstruction with perforation
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Info
Arrows indicate free subdiaphragmatic gas.
Case Discussion
Demonstrating evidence of perforation is very important as it usually results in an emergency laparotomy. As such looking for signs of free gas is essential.