Rigler’s sign and the football sign

Authors: Sheetal Daya, Nasreen Mahomed, Savvas Andronikou



Rigler’s sign was first described in 1941 by L G Rigler as a new radiological sign for recognising free air in the peritoneal cavity on supine radiograph. The presence of pneumoperitoneum allows free intraperitoneal air to be contrasted with intraluminal gas, accentuating the wall of gas-containing viscera. It is observed in infants and very ill patients where only limited radiographs of the abdomen are possible. The football sign was first described by R E Miller in the 1960s. Seen on supine abdominal radiographs, this describes an oval radiolucency resembling an American football. It is important for the radiologist to recognise the supporting signs of pneumoperitoneum, such as Rigler’s sign and the football sign, on supine abdominal radiographs, especially in neonates and infants, where erect chest/abdominal radiographs are not always possible.