Plain Abdominal Radiograph

Question 1

What is the most useful film in Abdominal plain radiograph?

What are the role of upright and CXR films in acute abdomen series?

Answer 1

Upright and CXR useful in detection of small amount of air, small bowel obstruction and unexpected thoracic disease (ที่ทำให้ผป.มาหาเราด้วยปวดท้อง)

Question 2

Please described

• Coverage bounderies of plain abdominal radiograph
• Center of x-ray beam
• Obtained image during inspiration or expiration ?

Answer 2

• Coverage bounderies:
  » Upper border cover both lung bases
  » Lower border cover pubic symphysis
• Center of beam at iliac crest.
• During expiration.

Question 3

ในการถ่ายภาพท่า left lateral decubitus ของ abdomen เพื่อหา free air ปริมาณน้อยๆ

1. มีการแนะนำ ให้นอนตะแคงนาน เท่าใด
2. ทำไมต้องตะแคงซ้ายลง

Answer 3

1. สิบนาที อย่างน้อย

2. เพื่อให้เงาของ ลม ไป contrast กับเงาตับ

Question 4

About normal anatomy of plain abdomen film.

• What are the normal measurement of liver?
• What is Riedel’s lobe and how to distinguish from the hepatomegaly ?

Answer 4

• 20-22 cm in transverse dimension
• 15-17 cm in vertical dimension near it right lateral border
• Riedel’s lobe อาจยาวลงมา iliac crest แต่ตัวมุม (tip of right lobe liver) จะเป็นมุมแหลม

Question 5

What are the image fingings of hepatomegaly?

5 ข้อ

Answer 5

1. Elevated right hemidiaphragm
2. Inferiorly Displaced hepatic flexure
3. Lateral displacement of lesser curvature
4. Inferomedial displacement of right kidney
5. Right hepatic tip below iliac crest or lower pole of kidney หรือมาอยู่บริเวณ lower abdomen

Question 6

• GB usually not visualize in plain abdomen.

Does the above statement is true?

Answer 6

Yes

It may visualized if it indents the surrounding fat.

Question 7

About anatomy of plain abdomen film.

• What are the normal measurement of spleen?
• What are the findings of splenomegaly? (3)

Answer 7

• Normal measurement
  &raquo_space; 12 cm in length
  &raquo_space; 7 cm in width
• Enlarge spleen findings on plain radiograph
  &raquo_space; elevated left hemidiaphragm
  &raquo_space; Medial displacement of gastric air
  &raquo_space; Splenic tip below left costal margin