Interpretations of abdominal X-Rays Flashcards
How to confirm patient details on AXR?
- Name
- Hospital Number
- DOB
- Date and time of X-ray
- Establish whether previous imaging is available
How to assess the image type?
- Assess projection of image
- Anterior-posterior (supine)
- Anterior-Posterior (erect)
- Exposure•Is the whole abdomen visible? (Diaphragm to pelvis)
- Are you able to see small bowel/large bowel?
What is this?
Normal AXR
Explain the interpretation of AXR
- Structured approach (BBC)
Bowel (and other organs – SB, LB, Lungs, Liver, GB, Stomach, psoas, Kidney, spleen, Bladder)
Bones (Ribs, vertebrae, sacrum, coccyx, pelvis)
Calcification (eg renal stones, Gallstones, aorta)•
What is the difference between the small bowel and large bowel?
- Distribution (SB usually lies centrally, with the large bowel ‘framing’ it)
- SB mucosal folds (Valvulae conniventes) – visible across full width of bowel
- Large bowel wall features haustra (thicker than valvulae conniventes and typically does not appear to traverse the width of the bowel)
- Faeces (mottled appearance in large bowel, due to air trapping in solid faeces)
What is circled in the AXR?
Faeces
What are the different diameters of the bowel?
- Upper limits
- Small bowel (3cm)
- Colon (6cm)
- Caecum (9cm)
What are the features of small bowel obstruction?
- Features:
- Dilatation of small bowel (>3cms)
- Prominent valvulae conniventes
What are the causes of small bowel obstruction?
- Causes:
- Adhesions (75%)
- Abdominal hernias
- Intrinsic/extrinsic compression (eg tumours)
What is this?
Small bowel obstruction
What are under-exposed AXR’s look like?
Lighter → harder to read
What does an over-exposed AXR look like?
Darker
What is this?
Gallstone ileus
What are the causes of large bowel obstruction?
Causes:
- Colorectal Cancer
- Diverticular stricture
- Hernia
- Volvulus
What is this?
Large bowel obstruction