• 20 years old female

• Two day history of

worsening right iliac
fossa pain.
• 55 years old female
• Abdominal pain and vomiting.
Generalised abdominal
tenderness. Involuntary guarding.
• 30 years old male
• Referred with clinical diagnosis of
right inguinal irreducible hernia.
• There is herniation of peritoneal
fat in inguinal canal; reaching upto
scrotum. There is no bowel in
hernia sac.
• Markedly dilated loop of colon
with a coffee-bean shape. Its apex
points toward the right upper
quadrant. Lucency at the right
edge of the dilated bowel most
likely represent compressed
ascending colon.
• Classic coffee bean sign (omega
sign) of sigmoid volvulus.
• 18 years old female
• Developed abdominal pain and
bowel obstruction
• soft tissue sausage shaped density
in the middle of the film reflecting
intussusception.
• Air enema, used to reduce the
intussuception
• 40 years old male with acute onset
abdominal pain
• Free air underneath the right
diaphragm. There is also air
underneath the central tendon of
the diaphragm, which is similar to
the cupola sign in supine.
Penumoperitoneum can be an
ominous sign, in this case it was
due to bowel infarction and
perforation