X-RayAbdomenIntermediate
Pneumoperitoneum (Rigler sign)
abdomenperforationemergencyfree airriglergastrointestinal
Clinical presentation
Patient with sudden severe abdominal pain and rigidity, a history of peptic ulcer disease and NSAID use.
Key imaging findings
- Rigler (double-wall) sign: gas outlining both sides of the bowel wall
- Free subdiaphragmatic gas on an erect chest radiograph
- Falciform ligament sign — the ligament outlined by free air
- Football sign in large-volume pneumoperitoneum
Form your diagnosis, then reveal the answer.
Educational teaching content only. Imaging appearances vary; always correlate clinically and confirm with a qualified radiologist.