Presentation
Generalized abdominal pain for 24 hours and more recent onset of vomiting. Previous surgical history includes laparoscopic sterilization 12 months previously.
Patient Data
Sterilization clips demonstrated in the pelvis. Normal outlines of solid organs - the liver has a prominent lower margin (normal variant - Riedel lobe). Normal bowel gas pattern. Feces in ascending colon.
No evidence of obstruction or perforation.
The liver and spleen are seen in the upper abdomen (colored blue). The liver extends quite low in the abdomen, but this can be a normal variant (Riedel lobe). The liver doesn't usually extend below the lower pole of the right kidney.
Both kidneys can also be demonstrated (yellow) and are held away from the spine by the psoas muscle.
The right colon (ascending colon) is filled with feces, but can be traced over the midline to the splenic flexure and then down the left flank towards the pelvis.
Case Discussion
The cause of the patient's symptoms are not demonstrated on this plain film. The bowel gas pattern is normal and there is no evidence of obstruction or perforation.
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