Radiology Tools for Abdominal Diagnosis

Chapter 10 Radiology Tools for Abdominal Diagnosis

3. Erect Abdominal Film (AP)

The erect abdominal radiograph is utilized to detect air-fluid levels in the GI tract, and “free” (extraluminal) intra-abdominal air. It is normal to have an air-fluid level present in the stomach on an erect film. Normally, minimal small bowel air is present and the small intestine should measure no more than 2.5 to 3.0 cm in diameter, with centrally located loops. The large bowel is located more toward the periphery of an abdominal radiograph, as the right colon, hepatic flexure, splenic flexure, and left colon generally have a fixed position. If a patient is too ill for an erect radiograph, a left lateral decubitus radiograph may be obtained.

Table 10-1 Calcifications Seen on Abdominal X-rays

Entity Notes
Gallstones 10% of gallstones are radiopaque. May be incidental finding.
Appendicolith Its presence is associated with appendicitis.
Chronic pancreatitis Multiple calcifications in pancreas.
Abdominal aortic aneurysm Look for calcium in aortic wall.
Nephrolithiasis/ureterolithiasis Stones may be apparent overlying kidney shadow. Ureteral stones may appear anywhere along course of ureter.
Gallstone “ileus” A gallstone large enough to block the ileocecal valve enters the bowel via a biliary enteric fistula from the gallbladder to the duodenum; usually the result of untreated chronic cholecystitis.
Uterine fibroids Calcified fibroids may appear in pelvis.
Dermoid cysts A dermoid is a mature teratoma that may manifest as a calcified “tooth” in pelvis.

Mar 20, 2017 | Posted by in GENERAL SURGERY | Comments Off on Radiology Tools for Abdominal Diagnosis
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