Acute abdominal series: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
*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: | 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 | Bowel Diameters: 3/6/9 rule | ||
*Small bowel - 3 cm | |||
*Colon - 6 cm | |||
*Cecum - 9 cm | |||
Revision as of 04:36, 9 April 2015
Background
- Differs from KUB in that patient is upright vs supine on KUB
Diagnosis
- 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