ABDOMINAL XRAY AXR INTERPRETATION Plain films of abdomen

ABDOMINAL XRAY (AXR) INTERPRETATION

Plain films of abdomen (AXR) are obtained as first step before any other imaging studies like Ultrasound, CT or MRI. The principles that guide the interpretation of conventional radiographs apply to the modalities of CT, MRI and Ultrasound also. Plain radiographs provide non-invasive widely and easily available less expensive imaging for diagnosing several acute abdominal problems and form the base- line for selection of further imaging like contrast studies and sectional imaging as well as interventional procedures. Therefore its essential that you develope ability to interpret AXR and recognize pathology. Always begin by checking following: Patient details( name /age /sex ) Date and time the film was taken Any previous imaging (useful for comparison} Assess quality of Radiograph Systematically review bowel gas -pattern , softtissues , extraluminal air and abnormal calcifications.

• Calcifications in abdomen

calcification contd

Multiple ur bladder calculi

Stag horn calculus

SUMMARY Look for these 4—bowel-gas pattern, free air, soft tissue masses and calcification. Usually air seen in stomach and colon. Rarely subtle air in small bowel. An air- fluid level in stomach is normal. 2 to 3 small air-fluid levels in undialted small bowel are normal. Usually no air-fluid level seen in colon. Supine film is asked for gas pattern and also serves as scout film. Erect film is for free air and air -fluid levels. Prone AXR is for gas in rectum/sigmoid /asc. & desc colon. Erect Chest film is for pneumoperitoneum, pneumonia, pl. effusion and herniation of bowel etc. Comparison with previous imaging if avaiable.