Acute abdominal series

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  • Differs from KUB in that patient is upright vs supine on KUB


  1. Films
    1. Upright chest film: r/o free air
    2. Upright abd film: air-fluid levels
    3. Supine abd film: width of bowel loops most visible (estimate of amount of distention)
  2. Air in colon or rectum makes complete obstruction less likely (esp if symptoms >24hr)
  3. If pt does not tolerate upright position left lateral decub abd film can substitute

To differentiate large and small bowel:

  1. Small bowel has lines (plica circulares) all the way through the bowel
  2. Large bowel has lines (haustra) only halfway through the bowel

Bowel Diameters: 3/6/9 rule

  1. Small bowel - 3 cm
  2. Colon - 6 cm
  3. Cecum - 9 cm

Abdominal x-ray has poor Sn and Sp for SBO

  • If concerned need CT

See Also