Abdominal X-Ray Interpretation

Question 1

Describe abdominal X-ray interpretation (B-O-L-D)

Answer 1

Question 2

How do you interpret the technical adequacy of AXR?

Answer 2

Technical adequacy: CRP

 Coverage – diaphragm to pubic symph, ideal skin laterally

 Penetration – vertebral bodies should be visible

 Rotation – less important than with CXR

Question 3

Describe normal stomach gas pattern.

Answer 3

May contain gas

Question 4

Describe normal small bowel appearance.

Answer 4

central, valvulae conniventes; contains small amount of gas and upper limit of diameter = 3cm

Question 5

Describe normal large bowel appearance.

Answer 5

Colon = peripheral with haustra; contains gas and faeces, upper limit is 6cm

Question 6

What is the maximum critical diameter of the caecum?

Answer 6

9cm

Question 7

What does dilatation of the small or large bowel indicate?

Answer 7

1. Obstruction
2. Ileus

Question 8

What is the differential diagnoses of paucity of gas (lack of gas in adbomen)?

Answer 8

Paucity of gas = small bowel obstruction, ascites, previous bowel resection, severe diarrhoea and vom or abdo mass

Question 9

What does bowel thickening/thumb-printing indicate (thickening of haustral folds)?

Answer 9

Colitis

Question 10

What is Rigler’s sign?

Answer 10

Pneumoperitoneum = Riglers signs = free intraabdominal gas adjacent to gas filled loop so walls of bowel are well defined - “double-wall sign”

Question 11

Sigmoid volvulus - coffee bean or fetal sign?

Answer 11

Coffee bean

Question 12

Caecal volvulus - coffee bean or fetal sign?

Answer 12

Fetal sign