Acute abdominal series

The acute abdominal series is a common set of abdominal radiographs obtained to evaluate bowel gas. 

The acute series is used for a variety of indications including: 

  • determine the amount of bowel gas, with possible bowel distention
  • asses air-fluid levels
  • query pneumoperitoneum

The studies should be obtained in this order. The majority of the information is obtained on the AP supine view 1. The erect view adds more information about air-fluid levels. The PA chest radiograph is the more sensitive view for pneumoperitoneum (and chest pathology can sometimes present as abdominal pain).

Modified acute series

The following is the modified acute series for patients who are unable to stand.

The studies should be obtained in this order. In this series, the left lateral decubitus view is the most sensitive for evaluation of intraperitoneal free gas.

In order to adequately evaluate for free intraperitoneal gas, the patient should be positioned in the erect and decubitus views for enough time to allow small amounts of free gas to drift up to the diaphragm or lateral liver edge, respectively. This often takes about 5-10 minutes.

Radiographic views
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Article Information

rID: 38095
Section: Radiography
Synonyms or Alternate Spellings:
  • Obstruction series

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Cases and Figures

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    Figure 1: PA erect view
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    Figure 2: AP supine view
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    Figure 3: lateral decubitus view
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    Figure 4: PA view showing perforation
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