Type:
Educational Exhibit
Keywords:
Education, Conventional radiography, Thorax, Abdomen, Perception image, Education and training
Authors:
E. Ilieva; Sofia/BG
DOI:
10.1594/ecr2013/C-2590
Imaging findings OR Procedure details
Three major findings:
- Free air beneath diaphragm (crescent sign)
- Visualization of both sides of the bowel wall (Rigler’s sign)
- Normally,
only the inside of the bowel (the lumen) is visible unless free air outlines the outer surface of the wall
- Visualization of the falciform ligament
- Long vertical line to the right of midline extending from ligamentum teres notch to umbilicus; a common structure outlined on the supine abdominal X-Ray
Right upper quadrant (RUQ) gas (for small collections in supine position):
- Anterior subhepatic space free air
- Oblique linear area of hyperlucency outlining the posteroinferior margin of liver
- Air Anterior to Ventral Surface of Liver
- Single large area of hyperlucency over the liver
- Doges Capsign
- Triangular area of free air trapped below central tendon of diaphragm
In cases of large pneumoperitonem the “continuous diaphragm sign” could be seen - the left and right hemidiaphragms contrasted by the free gas appear as a continuous structure in massive pneumoperitoneum.