Rigler sign - bowel
Abdominal pain and distension. Significant abdominal trauma 2 years earlier.
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Great example of Rigler sign of free intra-abdominal gas outlining distended small bowel loops. Multiple surgical clips are noted in keeping with the history of prior laparotomy for traumatic mesenteric injury.
This patient went to theater where an adhesive small bowel obstruction was found with a perforation just proximal to the adhesion.