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What's Wrong with This Picture?: Abdominal X-rays

12/21/2016

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Adapted from a lecture by Stas Haciski

Indications
  • rule out free air (sens 90% in upright)
  • look for foreign bodies
  • chronic abd pain with too many prev scans
  • constipation?


Basic Approach
  • check film position (upright, lateral decub, etc0
  • look at dark areas
  • look at light areas
  • check everywhere else
Picture
SBO
Picture
Structures on normal XR
Picture
Toxic megacolon
Picture
Pneumoperitoneum
Picture
PictureSmall bowel obstruction - coiled spring or slinky sign
Bowel Obstruction

3-6-9 rule
  • small bowel should be no larger than 3cm
  • colon should be no larger than 6cm
  • cecum should be no larger than 9cm

Abdominal Series includes:
  • supine abdomen
  • uprigt chest
  • upright abdomen

Tips
  • don't forget to run through the entire bowel
  • check soft tissues: liver, kidneys psoas muscles
  • don't get distracted by  foreign bodies and forget to assess other structures
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  • Clinical
    • Discharge Macros
    • Procedure Macros
    • Exam Macros
    • Pediatric Macros
    • Antibiogram
    • Follow Up
    • 2023 MDM
    • Heart Pathway
    • Jeromy's Macros
  • Education
    • EM Education
    • Critical Care
    • FOAM
  • Orientation
    • Dept Orientation
    • Cerner
    • Dragon
  • Links
    • Clinical Links
    • StatMacros
    • ICU Bootcamp
  • Private
    • MCS
    • GWU Contacts & Map