View source for Acute abdominal series/en

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==Technique==

3 Films:
#Upright chest film
#*Rule-out free air
#Upright abdominal film
#*Look for air-fluid levels
#Supine abdominal film (''KUB = just supine film'')
#*Width of bowel loops most visible (estimate of amount of distention)

''If patient does not tolerate upright position, left lateral decubitus abdominal film can substitute''


==Interpretation==

<gallery mode="packed">
File:Medical X-Ray imaging ALP02 nevit.jpg|Normal
File:SBO plain.png|[[Special:MyLanguage/Small bowel obstruction|Small bowel obstruction]]
File:Cecalvolvulus.png|Large bowel obstruction (Cecal [[Special:MyLanguage/volvulus|volvulus]]; black arrows).
File:Free air under diaphram.png|Free intra-abdominal air below the diaphragm.
File:Abdominal foreign body.png|Body-packing with multiple foreign bodies ("balls" of hashish).
File:Battery in stomach.png|[[Special:MyLanguage/Esophageal foreign body|Button battery in stomach.]]
File:StonesXray.png|[[Special:MyLanguage/Gallstones|Gallstones]] (not sensitive)
File:Toxisches Megacolon bei Colitis ulcerosa.jpg|[[Special:MyLanguage/Toxic megacolon|Toxic megacolon]]
File:Rectal_fb.JPG|[[Special:MyLanguage/Rectal foreign body|Rectal foreign body]]
</gallery>


===Differentiating large and small bowel===

{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Location'''
| align="center" style="background:#f0f0f0;"|'''Size'''
| align="center" style="background:#f0f0f0;"|'''Lines'''
|-
| Small bowel||3 cm||All the way through the bowel (plica circulares) 
|-
| Colon||6 cm||Only halfway through the bowel (haustra)
|-
| Cecum||9 cm||
|}


===[[Special:MyLanguage/Small bowel obstruction|Small bowel obstruction]]===

*Air in colon or rectum makes complete obstruction less likely (esp if symptoms >24hr)
*Abdominal x-ray has poor Sn and Sp for [[Special:MyLanguage/SBO|SBO]]
**If concerned need CT


==Indications==

*Ruling out free air under the diaphragm (e.g. perforated ulcer)
*Ruling out radio-opaque abdominal foreign body (e.g. swallowed battery)
*Ruling '''in''' bowel obstruction (i.e. to avoid need for subsequent CT scan)

;Do NOT use as the sole study to rule out bowel obstruction (poor sensitivity)
;Do NOT use to rule out generalized peritonitis (almost no sensitivity for diagnoses such as [[Special:MyLanguage/appendicitis|appendicitis]])
;Do NOT use to diagnose constipation (many patient with acute abdomen will have "copious stool")


==Incidental findings==

*[[Special:MyLanguage/Gallstones|Gallstones]] (not always radiodense)


==See Also==

*[[Special:MyLanguage/Abdominal pain|Abdominal pain]]

[[Category:GI]]
[[Category:Radiology]]