Rigler's sign

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Rigler's sign, also known as the double wall sign, is a radiologic sign seen on an x-ray of the abdomen when air is present on both sides of the intestine; a Rigler's sign is present when air is present on the inside (luminal side) and the outside (peritoneal side). Air in the peritoneum is considered abnormal, unless the patient had a recent abdominal surgery.

Double wall sign. This is a secondary sign of pneumoperitoneum. Patient is supine, and air within the abdomen and lumen of the bowel accentuate both sides of the bowel wall.

A false double wall sign can result from two loops of bowel being in contact with one another.[1]

The sign is named after Leo George Rigler. It is not the same as Rigler's triad.

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  1. ^ de Lacey G, Bloomberg T, Wignall BK. Pneumoperitoneum: the misleading double wall sign. Clin Radiol. 1977 Jul;28(4):445-8. PMID 872511.


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