Abdominal X-Ray PDF

Abdominal X-ray Projection: There are different projections that can be used to acquire abdominal X- ray, the most common used is the supine or erect anterior- posterior projection as the X-ray pass through the patient from front to back. (Fig.1.34&1.35) (Fig.1.34) supine A-p position...

Abdominal X-ray Projection: There are different projections that can be used to acquire abdominal X- ray, the most common used is the supine or erect anterior- posterior projection as the X-ray pass through the patient from front to back. (Fig.1.34&1.35) (Fig.1.34) supine A-p position Fig. (1.35): Normal abdominal x-ray (AP view). Interpretation Normal Gas Pattern on abdominal x-ray Any part of the bowel may be visible if it contains gas/air within the lumen. Gas/air is of low density and forms a natural contrast against surrounding denser soft tissues. It is often difficult to differentiate between normal small and large bowel, but this often becomes easier when the bowel is abnormally distended. The upper limit of normal diameter of the bowel is generally accepted as 3cm for the small bowel, 6cm for the colon and 9cm for the caecum (3/6/9 rule). Normal bowel sections are sometimes identified by the following feature (stomach, small and large bowel loops) are discussed before. Soft tissues: Soft tissue organs visible on abdominal X-rays include the liver, spleen, kidneys, psoas muscles, bladder (within pelvis), and lung bases (within thorax). ❖ Liver (Fig.1.36): The liver lies in the right upper quadrant (RUO) and is seen as a bland area of grey on an abdominal X-ray. The superior edge of the liver forms the right hemi-diaphragm contour (arrowhead). In this the breast shadow (red line) overlies the liver and markings of the right lung are visible behind the liver. Fig (1.36): liver shadow in abdominal X ray  ❖ Lung bases on abdominal x-ray (Fig.1.37): The lung bases, which pass behind the liver and diaphragm in the posterior sulcus of the thorax, may be visible on some abdominal A-ray. Costophrenic angle (asterisk). Fig. (1.37) Lung bases on abdominal x-ray ❖ Psoas edges on abdominal X-ray (Fig1.38): The psoas muscles (red) arise from the transverse processes of the lumbar vertebrae (arrowheads) and combine with the iliacus muscles. Together these powerful muscles form the iliopsoas tendon, which attaches to the lesser trochanter of the femur (asterisk). An abdominal X-ray often demonstrates the lateral edge of the psoas muscles as a near straight line. The iliacus muscles are not visible, as they are lying over the iliac bones of the pelvis. Fig (1.38) psoas muscle on x ray  ❖ Kidneys on abdominal X-ray (Fig1.39): The natural contrast between the kidneys and the low-density retroperitoneal fat that surrounds them means they are often visible on an x-ray of the abdomen. Fig (1.39) kidney and spleen on x ray ❖ Spleen on abdominal X-ray (Fig.1.39): The spleen lies in 0the left upper quadrant immediately superior to the left kidney. ❖ Urinary Bladder on abdominal X-ray(Fig.1.41): The bladder has variable appearance depending on how full it is. Fig (1.41) pelvis x ray Bones (fig 1.42) Bones visible on an abdominal X-ray include the lower ribs, the lumbar spine, the sacrum, coccyx, pelvis and proximal femora. All bones seen on an abdominal X-ray are better visualized with dedicated images. Bones can be used as a landmark for invisible soft tissue structures.eg the transverse processes of the lumber vertebrae are landmark for the course of the ureters (arrowheads). The vesico-ureteric junctions (asterisks) are located at the level of the ischial spine (arrows). The sacrum, coccyx, pelvic bone and proximal femora are highlighted. The sacroiliac joint is formed by the overlapping of the sacrum and iliac bones. Fig (1.42): labelled abdominal and pelvic x-rays