Pneumoperitoneum – Supine
Free peritoneal air is difficult to assess in a single, supine, plain film study.
However, in the study above, one can appreciate the air visualized on both sides of the left hemidiaphragm. [Courtesy of Dr. N. Jaffer]
Pneumoperitoneum – Riglers sign
Air both inside and outside of the bowel wall creates contrast effect enabling the visualization of both the inner and outer limits of the bowel wall. [Courtesy of Dr. N. Jaffer]
Pneumoperitoneum – Cupola sign
Cupola sign refers to peritoneal air that is superior to the left lobe of the liver, having the appearance of a long, flat hat, hence the term “cupola” meaning hat. [Courtesy of Dr. N. Jaffer
Pneumoperitoneum – Crescent sign
Crescent sign – Upright abdominal radiograph showing abnormal presence of air under the right hemidiaphragm (arrow; left image).
LLD abdominal radiograph showing air over the liver (arrow; right image).
[Courtesy of Dr. N. Jaffer]
Ascites – CT Massive
The image demonstrates massive ascites where fluid is seen throughout the abdomen, displacing the bowel centrally and superiorly as it is less dense than the fluid. Arrow points to ascites located in lesser sac.
[Courtesy of Dr. N. Jaffer]
Ascites – CT
On CT, a small amount of ascites may be appreciated in the hepato-renal fossa as demonstrated in the image. [Courtesy of Dr. N. Jaffer]
Ascites – AXR
Plain abdominal film findings of ascites include generalized ground glass appearance, bulging flank sign, loss of posterior liver edge, centrally floating bowel. The first x-ray film above depicts the ground glass appearance of ascites and the bulging flank sign well, while the second shows centrally floating bowel loops. [Courtesy of Dr. N. Jaffer]
