Abdominal (lateral view)

Last revised by Andrew Murphy on 19 Sep 2021

The lateral view abdominal radiograph is a less common projection of the abdomen, it is different from the lateral decubitus view of the abdomen and looks more like a lateral lumbar spine view.

This projection is often requested as a useful problem-solving view that can complement frontal views of the abdomen, often utilized in the context of foreign bodies or to better visualize lines such as a shunt (or a part of a dedicated shunt series).

  • the patient may be either erect or recumbent, with her or his side against the detector
  • legs may be flexed for balance
  • arms raised
  • lower bound of the field of view should contain the inferior pubic ramus
  • the x-ray is taken in full inspiration
  • supine lateral projection
  •  centering point
    • the midcoronal plane at the level of the iliac crest
  • collimation
    • anterior-posterior to the skin margins 
    • superior to the diaphragm
    • inferior to the level inferior pubic rami
  • orientation
    • portrait
  • detector size
    • 35 cm x 43 cm
  • exposure
    • 70-80 kVp
    • 30-120 mAs; AEC should be used if available
  • SID
    • 100 cm
  • grid
    • yes
  • the projection can be confirmed lateral via the lateral appearance of the vertebral bodies
  • skin border is not burnt out (a filter may be required to address this) 
  • no blurring of the bowel gas due to respiratory motion 
  • the lateral abdomen can be useful to visualize rectal gas and differentiate colonic ileus from a distal colonic obstruction however it does not offer much information about bowel gas from the frontal view 
  • this projection can be done erect or supine, often used to localize foreign bodies or as part of a shunt series when there is a high degree of winding of the line

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Cases and figures

  • Figure 1: lateral abdomen collimated to rectum
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  • Figure 2: normal shunt series
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