Puckered Panniculus

It can be difficult to ascertain the postoperative status of some patients in the absence of surgical clips, staples, or suture material. One possible clue to a prior surgical history is the "puckered panniculus" sign. Baker and Cho described this sign as the retraction of the abdominal wall caused by a longitudinal incision [118]. This results in a bilobed appearance to the anterior abdominal wall as it overlies the pelvis (Fig. 1.55).

Figure 1.55. "Puckered panniculus." Supine film of the abdomen reveals the soft tissues of the anterior abdominal wall having a bilobate appearance, with retraction in the midline. This so-called puckered panniculus sign is an excellent indicator of prior surgery.

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