Massive pneumoperitoneum is evident by the excessive free gas in the abdominal cavity, including the bilateral subphrenic spaces and surrounding the edges of the liver (hepatic edge sign). Bowel ​​double wall sign (or Rigler sign) is well-demonstrated.

Some of the bowel loops are significantly dilated. Gas-fluid levels are seen in the dilated lower abdominal loops. No rectal gas is seen.

#pneumoperitoneum #abdominalcavity #riglersign #doublewallsign #xray #radiology