Lecture 24 Abdomen Basic Projections Abdomen KUB Basic

Lecture (24)

• Abdomen Basic Projections Abdomen (KUB) Basic AP supine Special PA prone Lat decubitus (AP) AP erect Dorsaldecubitus (Lat) Lateral Acute abdomen Basic AP supine AP erect PA Chest erect ( page 86) Special Left lat decubitus Abdomen AP Supine Exposure Factors Kv m. AS FFD (cm) Grid Focus Cassette 70 -80 50 100 Yes Broad 35 x 43 cm

• Patient Position • • • Supine Part position Align midsagittal plane to table Shoulders in same transverse plane Support pillows under knees Center cassette to level of iliac crests Gonad shielding is recommended Exposed at end of expiration Central Ray perpendicular Center Point To mid line at level of iliac crests

• • Structure shown Out line of Liver, spleen kidneys, and air-filled stomach and bowel segments and • The arch of the symphysis pubis for the urinary bladder region • Note • For KUB Bowel preparation to remove gases and fecal masses is recommended

• Abdomen PA Prone Patient Position Prone Part position Align midsagittal plane to mid table Shoulders in same transverse plane Legs extended with support under ankles Center cassette to level of iliac crests Arms up beside head No rotation of pelvis or shoulders & thorax Exposure made at end of expiration Central Ray perpendicular Center Point To mid line at level of iliac crests

• Structure shown • Out line of Liver, spleen kidneys, and air-filled stomach and bowel segments and • The arch of the symphysis pubis for the urinary bladder region • Note • This projection is less desirable than the AP if the kidneys are of primary interest because of the increased object film distance (OFD)

• Abdomen AP Erect Patient Position Erect with legs slightly spread &back against stand bucky Part position Align midsagittal plan to mid bucky Do not rotate Shoulders or pelvis Adjust top of cassette at the level of the axilla With Center of cassette 2 -3 inches above iliac crests to include diaphragm Gonad shielding is recommended Exposure made at end expiration Central Ray Horizontal & perpendicular To Film Center Point To mid line 2 -3 inches above iliac crest

• Air-filled stomach and loops of bowel and air fluid level where present, Bilateral diaphragms as much of lower abdomen as possible should include AP erect Abdomen showing Air-fluid level

• Abdomen AP ( Lateral Decubitus ) Patient Position Lateral Recumbent on radiolucent bad Arms up near head Knees slightly flexed Part position Align midsagittal plane to mid vertical bucky Shoulders in same transverse plane Center cassette 2 inches above level of iliac crests Proximal margin of cassette will be approximately at Level of axilla Gonad shielding is recommended Collimate without cut of upper abdomen Ensure no rotation of shoulder or pelvis Exposure made at end of expiration

• Central Ray • Horizontal & perpendicular To Film • Center Point • 2 inches above level of iliac crest • Structure shown • Air-filled stomach and loops of bowel and air fluid level where present, Bilateral diaphragms as much of lower abdomen as possible should include • Notes • This projection for bed or stretcher patient to demonstrate air-fluid level • Patient should be onside a minimum 5 minutes before exposure to allow to raise or abnormal fluid to accumulate

• Abdomen lateral ( Dorsal Decubitus Patient Position Supine on radiolucent bad, side vertical aginst vertical bucky Arms up near head Support under slightly flexed Knees Part position Align mid-axillarly plane to mid vertical bucky Center cassette 2 inches above level of iliac crests Proximal margin of cassette will be approximately at Level of axilla Gonad shielding is recommended Collimate without cut of upper abdomen Ensure no rotation of shoulder or pelvis Exposure made at end of expiration

• Central Ray • Horizontal & perpendicular To Film • Center Point • 2 inches above level of iliac crest • Structure shown • Air-filled stomach and loops of bowel and air fluid level where present, Anterior abdomen and prevertebral regions • Notes • ordinary lateral abdomen obtained with the patient in upright erect position • This projection for bed or stretcher patient to obtain a lateral view for abdomen • and demonstrate air-fluid level