1. S4S: Abdo X-Ray
Megan Lloyd

2. Presenting an X-Ray Projection Patient details Adequacy
State obvious abnormality/that it is a normal x-ray
Systematic review of film
Summary

3. Projection
Supine AP
Also lateral or upright positions to visualise air-fluid levels
Assume it is supine AP unless otherwise stated

4. Patient Details
Name
DOB
Date
Time

5. A- Adequacy
Apparatus
B – Bones
‘C’ – Soft Tissues
- Calcifications
SMITH, Emma dob 12/03/1964
04/02/ :32

6. Adequacy Field – Diaphragm to groin
Adequacy of penetration (can you see the spinous processes?)
Alignment (is the patient twisted or lying flat?)
SMITH, Emma dob 12/03/1964
04/02/ :32

7. Apparatus Appear bright white on x-ray May be from Medical procedures
Piercings
Trauma
Ingested foreign bodies
“Curiosity”

9. IUD
SMITH, Emma dob 12/03/1964
04/02/ :32

10. Belly bar (external)
SMITH, Emma dob 12/03/1964
04/02/ :32

11. Uretal stent
SMITH, Emma dob 12/03/1964
04/02/ :32

12. Bones
Fractures
Abnormal Calcifications

13. Soft Tissue - Air Intraluminal Intramural: ischaemic colitis
Bowel obstrurction
3-6-9 rule:
Small bowel <3cm
Large bowel <6cm
Caecum <9cm
Intramural: ischaemic colitis
Extraluminal
Diaphragm in erect view: pneumoperitoneum

14. Haustra vs Plicae Circulares (valvulae conniventes)
Large Bowel Small Bowel

15. Small Bowel Obstruction valvulae conniventes/plicae circulares
Central location
>3cm
SMITH, Emma dob 12/03/1964
04/02/ :32

16. Large Bowel Obstruction Haustra Peripherally located >6cm
SMITH, Emma dob 12/03/1964
04/02/ :32

17. Sigmoid volvulus Coffee bean sign! SMITH, Emma dob 12/03/1964
04/02/ :32

18. Ischaemic Colitis Thumbprint sign SMITH, Emma dob 12/03/1964
04/02/ :32

19. Pneumoperitoneum

20. Apple Core Sign
Colon Cancer
Barium enema

21. Calcifications
Kidney Stone
Staghorn

22. Quiz!

23. Small Bowel Obstruction
SMITH, Emma dob 12/03/1964
04/02/ :32

24. Sigmoid volvulus
SMITH, Emma dob 12/03/1964
04/02/ :32

25. Colon Cancer
SMITH, Emma dob 12/03/1964
04/02/ :32