Presentation
Acute epigastric pain with bloating
Patient Data
Age: 35 years
Gender: Female
From the case:
Pneumoperitoneum due to perforated duodenal ulcer
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Massive free intraperitoneal gas with postive Rigler sign, i.e. gas on either side of the bowel wall seen on the anterior scout view. Note the defect in the duodenal cap posteriorly with gas leaking out (arrow) = site of perforation.