Endgames Spot Diagnosis

Losing a marble

BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i4486 (Published 26 August 2016) Cite this as: BMJ 2016;354:i4486
  1. Adrian Iordache, foundation year 2 house officer1,
  2. Paul Young, foundation year 1 house officer1
  1. 1James Cook University Hospital, Middlesbrough, UK
  2. Correspondence to: [email protected]

A 44 year old woman with no medical history presented with abdominal pain, vomiting, and lack of bowel movement for four days. Apart from an increased bilirubin level (32 μmol/L, range: <21 μmol/L) blood markers were unremarkable. What is the eponymous radiological finding and diagnosis in this plain abdominal radiograph (fig 1)?

Fig 1

Answer

Rigler’s triad, pathognomic of …

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