Acute abdominal series: Difference between revisions
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[[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:SBO plain.png|thumb|[[Small bowel obstruction]]]] | ||
[[File:Free air under diaphram.png|thumb|Upright chest radiograph demonstrating free intra-abdominal air below the diaphragm. (Black arrows demonstrate the air below the diaphragm)]] | |||
[[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 19:14, 4 May 2015
Background
- Differs from KUB in that patient is upright vs supine on KUB
Diagnosis
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