What causes Falciform ligament sign in abdomen on plain radiograph?
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Answer:
Visualization of linear soft-tissue density outlining the falciform ligament due to surrounding free intraperitoneal air in pneumoperitoneum, typically from gastrointestinal perforation; enhanced visibility on CT or with contrast/edema in peritonitis. (This is the Falciform ligament sign.)
Why is it called so?:
Named for the falciform ligament, a sickle-shaped peritoneal fold connecting the liver to the anterior abdominal wall, which becomes outlined and visible against free air or fluid.
Pathophysiology:
Free intraperitoneal air from hollow viscus perforation rises in supine position to outline the normally inapparent falciform ligament anterosuperiorly on the liver surface; requires large-volume pneumoperitoneum; in peritonitis, ligamental edema or leaked contrast highlights it mechanistically via surrounding low-density medium.
Alternative names: Silver sign
Other associated named signs: Rigler sign, ligamentum teres sign
Access all radiology signs posted so far: https://radiogyan.com/radiology-signs/
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