Evaluation of Plain Abdominal Radiograph Plain xray of
Evaluation of Plain Abdominal Radiograph
Plain x-ray of the abdomen � Standard ü supine plain films: AP ü erect AP ü Lt. lateral decubitus
What to examine? � gas pattern : intraluminal , intramural � Exrtraluminal � Soft gas tissue masses � Calcification
Normal gas pattern 1. 2. 3. 4. 5. What segment ? The caliber ? The most distal point ? The gut mucosa ? Air - fluid levels ?
Normal gas pattern � The stomach: � Location � Pattern � fluid level
Normal gas pattern Small bowel Caliber � Location � Pattern � fluid levels �
Normal gas pattern � Large bowel Caliber � Location � Pattern � fluid levels �
How to distinguish between normal small & large bowel gas pattern � The Location � Assessment of mucosal pattern : 1. Plicae circularis 2. Colonic haustra � Number of loops � Lower ileum & sigmoid colon ? ?
Normal fluid levels � Usually seen in erect position Ø Stomach Ø Duodenum Ø Small bowel Ø Large bowel
Dilatation of bowel � Mechanical � Paralytic � Acute obstruction ileus ischemia � Inflammatory bowel disease
Mechanical small bowel obstruction -Causes : -Features:
Mechanical large bowel obstruction -Causes : -Features:
Generalized Paralytic ileus � Causes : � Features of dilated large & small bowel � Gas is seen within the rectum
Localized ileus � Causes : � Features
Closed loop obstruction � Sigmoid volvulus :
Toxic dilatation of the colon � Causes � Features � Barium enema is CONTRAINDICATED
Free intraperitoneal air � ERECT FILMS , additional views � Causes � Features
Intramural gas � Pneumatosis
Intramural gas � Bowel wall ischaemia
Abdominal calcification � Assess : Ø the location (two views) , Ø the pattern Ø the shape � Common calcifications
Patterns of abdominal alcifications � Rim like � Linear � Lamellar � Cloudy
Rim like calcification � Causes
Linear calcification � Causes
Lamellar or laminar calcification � Causes
Amorphous or cloudy calcification
Soft tissue masses in the abdomen � In normal subject 1. Lateral & inferior edge of liver Spleen Both kidneys Psoas muscles UB Uterine indentation 2. 3. 4. 5. 6.
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