Abdominal x-ray (summary)

This is a basic article for medical students and other non-radiologists

Abdominal radiographs can be a useful examination, but you need to think about the question you are asking before getting the test. Before the advent of computerised tomography (CT) imaging, it was a primary means of investigating gastrointestinal pathology (and often allowed indirect evaluation of other abdominal viscera). 

Reference article

This is a summary article; read more in our article on abdominal radiography.

Summary

• indications (acute)
  • emergent evaluation of bowel gas
    • negative study in some patients may obviate the need for CT
  • evaluation of radiopaque lines and tubes
  • evaluation of radiopaque foreign bodies
  • evaluation of postprocedural free gas
  • evaluation of bowel gas in postoperative ileus
• important pathology
  • bowel obstruction
  • sigmoid volvulus
• benefits
  • quick and accessible
• limitations
  • modest radiation dose
  • low sensitivity and specificity for intra-abdominal pathology
  • pregnancy is a relative contraindication
• procedure
  • patient is supine
  • radiograph is performed AP (anteroposterior)
  • performed in the radiology department
    • mobile abdominal radiographs are poor quality
    • only performed mobile if the patient is very ill

Similar tests

• US abdomen
  • performed for specific indications
    • useful for gallstones
    • useful for liver and renal pathology
• CT abdomen
  • far more sensitive and specific for intra-abdominal pathology
  • significantly greater radiation dose