PLAIN ABDOMINAL X-RAY. in radiology report

Plain abdominal X-ray, in radiology

1. PLAIN X-RAY
1.Erect abdomen
2.supnie abdomen
3.Lateral abdomen
4.Erect CXR
By
DR Aliyu Abdulhamid Hussaini
MSc Radiology
BUK

2. OUTLINE
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ERECT ABDOMEN
SUPINE ABDOMEN
LATERAL ABDOMEN
ERECT CXR
CONCLUSION

3. INTRODUCTION
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Almost most of the Radiology department
has a series of radiographic images that is
routinely obtained in patient who have
acute abdominal pain.
These series are some time called
‘obstruction series’ ‘acute abdominal
series’ or ‘complete abdominal series’ or
something similar.

4. ERECT ABDOMEN
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What is it good for?
Seeing free air in the peritoneal cavity
Seeing air-fluid levels within the bowel lumen
How is it obtained?
The patient stands or sits up and the
exposure is made with the x-ray beam
directed horizontally, parallel to the plane of
the floor
Substitute view left lateral decubitus position

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The right lateral decubitus position if
obtained the normal stomach bubble as
well as gas in the spleenic flexure of the
colon could be mistaken for free air.
To see the free air the x-ray beam must be
directed horizontally, parallel to the floor
when decubitus view is obtained.

6. SUPINE ABDOMEN
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What is good for?
Overall appearance of gas pattern
How much air and fluid there is and its
likely location.
Identifying the presence or absence of
calcification
Identifying the presence of soft tissue
masses

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How is obtained
Patients lie on their back on the x-ray table
or strecher and the x-ray beam is directed
vertically downward
Substitute view
No other view really substitute this as
virtually all patients regardless their
condition can tolerate this examination

8. LATERAL ABDOMEN
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Usually form a substitute for erect
abdomen when patient can not stand or sit.

In Left lateral decubitus the patient lies on
their left side on the x-ray table and free air
will distribute it self at the highest part of of
the abdominal cavity on the patients right
side

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Free air should be easily visible over the
outside edge of the liver where there is
normally no bowel gas present.

If lateral decubitus is obtained bubbles in
the stomach and left splenic flexure of the
colon should not be misinterpreted as
pathology

10. ERECT CXR
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What is it good for ?
Seeing free air beneath the diaphragm
Finding pneumonia at the lung bases,
which might mimic the symptoms of an
acute abdomen
Finding pleural effusions which could be
secondary to an intraabdominal process
and help identify its presence.

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Pancreatitis, for example may be
associated with left pleural effusion
Some ovarian tumors may occasionally be
associated with right sided or bilateral
pleural effusions.
An abscess beneath the right
hemidiaphragm(subphrenic abscess) may
be associated with a right pleural effusion.

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How is obtained
The patient stands or sits up and an exposure
of the thorax is made using a horizontal x-ray
beam
Substitute view
Patient with sign and symptoms of acute
abdomen find it difficult to tolerate standing
for an upright of their chest.
In those cases supine view of the chest may
be obtained with patient lying on stretcher or
x-ray table.

13. Summary/conclusion
VIEW LOOK FOR
ERECT ABDOMEN FREE AIR, AIR-FLUIDS LEVELS IN THE
BOWEL
SUPINE ABDOMEN OVERALL GAS PATTERN,
CALCIFICATION, MASSES
ERECT CHEST FREE AIR, PNEUMONIA,PLEURAL
EFFUSIONS
LATERAL ABDOMEN (SUBSTIUTE FOR ERECT ABDOMEN)