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 . This results in a bilobed appearance to the anterior abdominal wall as it overlies the pelvis (Fig. 1.55).
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