Abdominal x-ray review: artifacts/external

Last revised by Dr Vikas Shah on 29 Apr 2022

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 X refers to the assessment of external objects and artifacts.


  • introduction
    • numerous different types of foreign bodies and artifacts, both medical and non-medical, can be seen on an abdominal radiograph
  • procedure
    • identify any artifacts or foreign bodies on the radiograph
    • correlate the finding with the clinical history provided, or seek further clarification from the referrer to help identify the object
    • try to localize the object to the abdominal wall or within the abdominal cavity
    • clothing or jewelry are commonly identified, these include:
      • navel/nipple/genital piercing
      • metal from clothing, e.g. metal rings from jogging bottoms, beads, sequins
      • metal objects in shirt/trouser pockets: cellphone, car keys, lighter, pen
      • printed shirts
    • many objects are placed iatrogenically, some are the result of misadventure

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Cases and figures

  • Case 1: belt artifact
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  • Case 2: vascular stents
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  • Case 3: colonic transit markers
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  • Case 4: peritoneal dialysis catheter
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  • Case 5: patency capsule
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  • Case 6: intrauterine contraceptive device
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