Pseudopneumoperitoneum in chronic intestinal pseudo-obstruction: A case report

Figure 1 Upright (A) and supine (B) films in a female patient complaining of long-lasting constipation, with recurrent episodes of abdominal pain and distension. A: An isolated air-fluid level is depicted in the left flank, suggesting mechanical obstruction at the level of the descending colon. Subphrenic radiolucency is evident on both sides, together with the outlining of the intestinal wall of some small bowel loops in the right flank (arrowheads) and that of the inferior cardiac border (arrows); B: Outline of the intestinal wall of small bowel loops appears to be depicted in the right flank (arrowheads), configuring the so-called bas-relief or Rigler’s sign. In addition, hyperlucency is depicted in the right subphrenic space in place of the normal hepatic shadow, configuring the bright or hyperlucent liver sign (*).