Acute abdominal series: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
[[File:Medical X-Ray imaging ALP02 nevit.jpg|thumb|Normal]] | [[File:Medical X-Ray imaging ALP02 nevit.jpg|thumb|Normal]] | ||
[[File:SBO plain.png|thumb|[[Small bowel obstruction]] | |||
[[File:Cecalvolvulus.png|thumb|Cecal [[volvulus]]. Featureless dilated gas filled viscus, representing the volved caecum, in the left upper quadrant (black arrows) and small bowel obstruction (white arrows). No colonic gas is identified.]] | [[File:Cecalvolvulus.png|thumb|Cecal [[volvulus]]. Featureless dilated gas filled viscus, representing the volved caecum, in the left upper quadrant (black arrows) and small bowel obstruction (white arrows). No colonic gas is identified.]] | ||
*Films | *Films | ||
Revision as of 19:10, 4 May 2015
Background
- Differs from KUB in that patient is upright vs supine on KUB
Diagnosis
[[File:SBO plain.png|thumb|Small bowel obstruction [[File:Cecalvolvulus.png|thumb|Cecal volvulus. Featureless dilated gas filled viscus, representing the volved caecum, in the left upper quadrant (black arrows) and small bowel obstruction (white arrows). No colonic gas is identified.]]
- Films
- Upright chest film: r/o free air
- Upright abd film: air-fluid levels
- Supine abd film: width of bowel loops most visible (estimate of amount of distention)
- Air in colon or rectum makes complete obstruction less likely (esp if symptoms >24hr)
- If pt does not tolerate upright position left lateral decub abd film can substitute
To differentiate large and small bowel:
- Small bowel has lines (plica circulares) all the way through the bowel
- Large bowel has lines (haustra) only halfway through the bowel
Bowel Diameters: 3/6/9 rule
- Small bowel - 3 cm
- Colon - 6 cm
- Cecum - 9 cm
Abdominal x-ray has poor Sn and Sp for SBO
- If concerned need CT