X-ray examination of the abdomen, called X-ray abdomen for short (synonyms: abdominal X-ray; abdominal overview, abdominal overview), together with abdominal sonography (ultrasound examination of the abdominal organs), is part of the basic diagnostics of the abdomen (belly). Both examinations point the way for further diagnostics or already give indications for suitable therapeutic measures. X-ray abdomen is a native image of the abdomen without the use of contrast medium.
Indications (areas of application)
- Aerobilie – detection of free air
- Acute abdomen – acute symptomatology of disease in the abdomen (abdominal cavity) requiring emergency treatment.
- Gas in the intestinal wall or portal vein in advanced ischemia (tissue death due to oxygen loss).
- Foreign body
- Ileus (intestinal obstruction)
- Detection of calcifications or calculi (eg, gallstones).
- Perforation of a hollow organ – e.g., the intestine.
- Subileus (incomplete intestinal obstruction).
- Toxic megacolon – toxin-induced paralysis and massive dilatation of the colon (widening of the colon; > 6 cm; lack of haustration/pleating of the colon), which is accompanied by acute abdomen (most severe abdominal pain), vomiting, clinical signs of shock and sepsis (blood poisoning); complication of ulcerative colitis; lethality (mortality related to the total number of people suffering from the disease) is about 30%.
- Tumors
- Detection of calcifications (lymph nodes, vessels, pancreas / pancreas) or concrements for example gallstones, kidney stones.
The procedure
X-ray abdomen is often used as an emergency and mostly at the beginning of more extensive diagnostics (possibly with the use of X-ray contrast medium). The patient does not need to be educated in any special way. However, a careful medical history must be taken beforehand. The examination is a conventional X-ray examination. The examination is performed in the following positions:
- Standing
- In left lateral position
- In supine position
Depending on the indication and on the patient’s ability to move, a position is selected. The image in the supine position is made with a. p. beam path (anterior posterior beam path – the X-rays penetrate the patient’s tissues from the front and are registered by the X-ray detector at the back of the patient). Due to the radiation exposure, pregnancy in female patients should be excluded. Depending on the problem, the examination should visualize or diagnose the following structures and allow the physician or radiologist to make a report:
- Intestinal gas distribution
- Free air in the abdominal cavity
- Air in bile ducts
- Air in portal vein system
- Air in the intestinal wall – due to infection with gas-forming bacteria.
- Air and fluid levels in the intestine – a sign of ileus (intestinal obstruction).
- Organ changes – gastrointestinal tract, liver, spleen and pancreas (pancreas).
- Calcifications (lymph nodes, vessels, pancreas) or concrements for example gallstones, kidney stones.
- Assessment soft tissues
- Texture of the psoas shadow
- Texture of the bone structures
