Nonendoscopic Imaging Studies

Abstract

The plain abdominal radiograph is a simple and readily accessible but nonspecific examination for the diagnosis of abdominal diseases. Interpretation of the abdominal X-ray is based on the distribution of fluid, calcification, and gas. Interpretation of the diameter of the bowel loops, bowel wall thickening, and the presence of gas in the bowel wall, blood vessels, biliary tree, and peritoneal cavity can help to establish a diagnosis. Erect abdominal X-rays are now rarely performed in clinical practice, but the interpretation of the number and length of fluid levels on an erect film can still be useful in the diagnosis of obstruction. Bowel obstruction can be identified on an abdominal X-ray, and perforation can be seen on a supine abdominal X-ray and an erect chest X-ray (Fig. 17.1), but generally the cause of the perforation cannot be determined, and further cross-sectional imaging is often performed.