Abdominal x-ray review: air
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Abdominal x-ray review is a key competency for medical students, junior doctors and other allied health professionals. Using ABDO X is a helpful and systematic method for abdominal x-ray review, where A refers to the assessment of the presence and location of air.
- air should only be within bowel loops
- free peritoneal air is known as pneumoperitoneum
- erect chest x-rays are more sensitive to the presence of pneumoperitoneum than abdominal x-rays
- however, there are some key signs on abdominal x-rays of a pneumoperitoneum
- look at the wall of the bowel - is it seen as a crisply defined thin white line (Rigler's sign)?
- can you see small triangles of air between bowel loops?
- can you see the falciform ligament outlined by gas on either side?
- does the liver look more lucent than expected?
- other signs of pneumoperitoneum are listed here