ABDOMINAL RADIOGRAPHY, Lecture notes of Radiography

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ABDOMINAL

RADIOGRAPHY

COURSE CONTENT

• 8.00 : Plain radiography of the abdomen
• 9.00 : Break
• 9.10 : Outdoor education ‐> Room No 13.
• 9.50 : Break
• 10.00 : Gastrointestinal study
• 11.00 : Film quiz
• 12.00 : Lunch

PLAIN RADIOGRAPHY OF THE ABDOMEN

• Plain abdominal radiography is traditionally the

first radiological investigation in acute abdomen

• Interpretation of plain films presents with

formidable challenge

ABDOMINAL X‐RAY VIEWS

• The standard view : Anterior–posterior (AP) supine

abdominal X-ray

• In acute abdomen series : abdomen supine AP and

upright, CXR PA upright

ABDOMINAL X‐RAY VIEWS

• Addition view :
  • Upright : Its advantage over a supine film is the

visualization of air/fluid level

• Decubitus : Also of use in certain situation,

especially to visualize fluid levels in the large bowel

RADIOGRAPH QUALITY :

The entire anatomy ‐> included from the

hemi‐diaphragms to the pubic symphysis

PLAIN RADIOGRAPHY OF THE ABDOMEN

Normal Anatomy : Five main densities

• Air/Gas ‐ Black
• Fat ‐ Slightly darker gray
• Soft tissue/Water ‐ Gray
• Calcification/Bone ‐ White
• Metallic object ‐ Bright white

NORMAL ANATOMY ON AN ABDOMINAL X‐RAY

Right and Left

• Remember, as you look at an abdominal radiograph the left side of theimage is the patient’s right side, and the right side of the image is the patient’s left side
• Always describe findings according to the patient’s side

NORMAL ANATOMY ON AN ABDOMINAL X‐RAY

NORMAL ANATOMY ON AN ABDOMINAL X‐RAY

1. Liver
2. Spleen
3. Location of the pancreas (white outline) – not normally visualized

OVERVIEW OF THE ABCDE OF ABDOMINAL RADIOGRAPHS

• Important to use a systematic approach when looking

at an abdominal radiograph

1. Abnormal bowel gas pattern
2. Extraluminal air
3. Soft tissue mass
4. Calcifications

ABNORMAL BOWEL GAS PATTERN

How to look?

• Look at the bowel loops for small or large bowel

dilatation

• Look for a very large dilated loop of bowel that could

represent a sigmoid or cecal volvulus