Abdominal x-ray (summary)

Last revised by Craig Hacking on 2 Apr 2018
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.

  • 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
  • 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

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