Abdominal x-ray
Encyclopedia
An abdominal x-ray is an x-ray
Projectional radiography
Projectional radiography or plain film radiography is the practice of producing two-dimensional images using x-ray radiation. Radiographic exams are typically performed by Radiologic Technologists, highly trained medical professionals who specialize in the usage of radiographic equipment, patient...

 of the abdomen
Abdomen
In vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...

. It is sometimes abbreviated to AXR, or KUB (for kidneys, ureters, and urinary bladder
Urinary bladder
The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...

).

Diagnostic Tool

The abdominal x-ray is a test that can be carried out quickly and easily in an emergency department. The test can help diagnose some abdominal conditions. It is not a useful investigation for most abdominal conditions. Small and large bowel obstructions, volvulus and malrotations can be diagnosed by AXR. Renal, urethral and bladder stones can sometimes be identified on plain x-ray, although it is usual now to use CT as a first line investigation to confirm clinical suspicion. Gallstones are sometimes noted on x-ray, although ultrasound is the more usual imaging modality used when clinically suspected. Plain abdominal radiography is not usually helpful in diagnosis of appendicitis.

Technical Parameters

An abdominal x-ray is usually taken with the patient lying in a supine position
Supine position
The supine position is a position of the body: lying down with the face up, as opposed to the prone position, which is face down, sometimes with the hands behind the head or neck. When used in surgical procedures, it allows access to the peritoneal, thoracic and pericardial regions; as well as the...

. Other views include upright, decubitus, lateral, and prone. Coverage on the x-ray should include from the top of the Liver (or diaphragm
Thoracic diaphragm
In the anatomy of mammals, the thoracic diaphragm, or simply the diaphragm , is a sheet of internal skeletal muscle that extends across the bottom of the rib cage. The diaphragm separates the thoracic cavity from the abdominal cavity and performs an important function in respiration...

) to the pubic symphysis
Pubic symphysis
The pubic symphysis or symphysis pubis is the midline cartilaginous joint uniting the superior rami of the left and right pubic bones. It is located anterior to the urinary bladder and superior to the external genitalia; for females it is above the vulva and for males it is above the penis...

. The abdominal organs included on the xray are the liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...

, spleen
Spleen
The spleen is an organ found in virtually all vertebrate animals with important roles in regard to red blood cells and the immune system. In humans, it is located in the left upper quadrant of the abdomen. It removes old red blood cells and holds a reserve of blood in case of hemorrhagic shock...

, stomach
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...

, intestines, pancreas
Pancreas
The pancreas is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, and somatostatin, as well as a digestive organ, secreting pancreatic juice containing digestive enzymes that assist...

, kidneys, and bladder
Urinary bladder
The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...

.

Pathology

In an acute setting the abdominal x-ray is used to diagnose:
  • Bowel obstruction
    Bowel obstruction
    Bowel obstruction is a mechanical or functional obstruction of the intestines, preventing the normal transit of the products of digestion. It can occur at any level distal to the duodenum of the small intestine and is a medical emergency...

  • Bowel perforation although this is more commonly diagnosed by a Chest x-ray
    Chest X-ray
    In medicine, a chest radiograph, commonly called a chest X-ray , is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures...

  • Pancreatitis
    Pancreatitis
    Pancreatitis is inflammation of the pancreas. It occurs when pancreatic enzymes that digest food are activated in the pancreas instead of the small intestine. It may be acute – beginning suddenly and lasting a few days, or chronic – occurring over many years...

     - Does not diagnose pancreatitis and is usually normal in pancreatitis
  • Kidney stones or Gall stones Further tests are used to confirm these diagnoses and abdominal x-ray is not the investigation of choice
  • Faecal impaction although this should be diagnosed by history taking and clinical examination

See also

  • X-ray
    X-ray
    X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...

  • Acute abdomen
    Acute abdomen
    The term acute abdomen refers to a sudden, severe abdominal pain of unclear etiology that is less than 24 hours in duration. It is in many cases a medical emergency, requiring urgent and specific diagnosis...

  • Abdominal pain
    Abdominal pain
    Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of abdominal pain can be difficult, because many diseases can result in this symptom. Abdominal pain is a common problem...

  • Medical imaging
    Medical imaging
    Medical imaging is the technique and process used to create images of the human body for clinical purposes or medical science...

  • Chest x-ray
    Chest X-ray
    In medicine, a chest radiograph, commonly called a chest X-ray , is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures...

  • Radiographer
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