Abodomen Flashcards
indications for abdomen x-ray
- Acute abdomen pain
- ? obstruction
- localisation of FB
- calcification
- ? renal colic
- mass
areas to review on AXR
areas of interest
abdominal structures and their location
soft tissue
calcifications
gas pattern
Distention
sufficient air within the bowel
Dilation
abnormal
bowel is distended above normal limits
mechanical obstruction
physical/organic obstructing lesion that prevents the passage of bowel contents
latrogenic
caused/paused by the treatment of physician
gas pattern for small bowel
1-2 loops of bowel
normal diameter is less than 2.5cm
Valvulae conniventes
Gas pattern- large bowel
see air in rectum and sigmoid
normal measurements 6cm and 9cm for caecum
radiographic appearances small bowel
multiple dilated loops of gas (centrally located)
The valvulae conniventes can be seen across
the entire lumen (stack of coin appearance)
clinical indications small bowel
distended abdomen and vomiting
clinical indications for large bowel
Abdo pain with failure to pass stools
radiographic appearances for large bowel
dilated loops of the bowel greater than 5cm
marked distension of the caecum
Generally peripheral in location
haustra does not cross fully along lumen
what is a volvulus
twisting if the bowel its mesenteric
attachment to abdominal wall
What is a complication of a volvulus?
Obstruction and
Ischaemia
which bowel is involved in volvulus
large bowel
common sites for volvulus
caecum and sigmoid
clinical indications for volvulus
Patient suffering with constipation
Abdominal pain
radiographic appearances for volulus
Dilated loop of bowel with a coffee bean shape
Bowel loop points to the right upper quadrant
therefore more likely to be sigmoid volvulus
loss of haustra
caecal volvulus Radiographic appearances
Caecum is dilated
embryo sign
not located within RLQ
clinical indications for caecal volvulus
nausea, vomiting, abdominal distention
Inflammatory bowel disease
thickening of the bowel wall
radiographic appearances of colitis
Loss of bowel wall shape
thumbprinting pattern within large bowel
what is colitis
thickening of the fold of haustra
both sides of the folds are outlined by gas
what is colitis
thickening of the fold of haustra
both sides of the folds are outlined by gas
colitis is caused by
Infection
- Ischaemia
- Inflammation
clinical indications of toxic megacolon
Acute abdominal pain
- Sepsis
- Known history of ulcerative colitis
radiographic appearances of toxic megacolon
Gross dilatation of the large bowel
- Bowel wall oedema (thumbprinting)
- mottled appearance
what is extraluminal air
air within the abdominal cavity, where it shouldn’t be
extraluminal air causes
significant dilation of the bowel
extraluminal air common sites
within the large bowel, sigmoid, duodenum
extraluminal air plain film projections
Erect CXR - pt sits up 10 mins for air topresent under diaphragm
horizontal beam ray, straight tube
clinical indications for pneumoperitoneum
abdominal pain post colonoscopy
radiographic appearances of pneumoperitoneum
dilation of large bowel
rigler’s sign- double walled sign - air seen on both sides of intestine
dark crescents of gas seen under hemidiaphragms
football sign - abdominal cavity outlined by gas
calcifications
