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Radiography of the abdomen
Procedure: Xray
Bodypart: Abdomen
Patient Group: Female Male Child
Summary
Synonyms: Plain abdominal X-ray, conventional abdominal X-ray
Abdominal radiography continues to be an examination frequently performed in clinical routine. As the examination features
low exposure to radiation compared to the CT of the abdomen and is cost-effective, it is used alongside sonography as a firstline diagnostic procedure for abdominal pain, nausea, vomiting, back pain or flank pain and in the search for swallowed foreign
bodies.
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Technique
What it is
Abdominal radiography is a conventional X-ray procedure where the patient lies on their back on an examination table, which
contains a digital detector or an X-ray film system. After taking a so-called plain X-ray while lying down, another X-ray while
standing might be necessary. If this is not possible, another X-ray might be taken while the patient is lying on their left side,
with their arms above their head.
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Purpose
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An abdominal X-ray shows the distribution of air (stomach, small and large
intestines), the density of organs (liver, spleen, kidneys and urinary bladder) as
well as their size, shape and location. It also shows the diaphragm, which is the
muscle separating the chest from the abdomen. The distribution of stool in the
large intestine is evaluated, too. An abdominal X-ray allows for detection, and
consequently treatment, of a great variety of disorders of the abdominal cavity.
Examples of these are: an obstruction of the small or large intestine (signs of
ileus) in terms of distended intestinal loops or an abnormal distribution of gas and
fluids; free air in the abdominal cavity (outside the hollow organs), e.g. caused by
an injury of the hollow organs (perforation); thickening of the intestine walls, e.g.
by inflammation; radio-opaque stones in kidneys, ureters or bladder; sometimes
gall stones as well as foreign bodies and the positioning or malpositioning of
catheters. In some cases, it is necessary to perform further examinations, such
as ultrasound, endoscopy, examinations of the intestines with contrast agent,
an intravenous pyelography (IVP) or a computed tomography.
Radiography of the abdomen
© GH Vienna
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Target Patient Group
Abdominal X-rays are performed for various diagnostic tasks. Examples are: A suspected obstruction of the small or large
intestine (signs of ileus), injury of a hollow organ in the abdominal cavity (free air in the abdominal cavity), thickening of the
intestine wall (e.g. within the scope of inflammations), radio-opaque stones in kidneys, ureters or bladder, as well as foreign
bodies and the positioning or malpositioning of catheters.
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Procedure
Persons
You will be looked after by an experienced team consisting of a medical radiology technician (MRT) and a radiologist. The
procedure itself is performed by the MRT. The assistant will ask you to briefly hold your breath in order to avoid artifacts (errors)
in the image caused by breathing.
The radiologist examines and assesses the images after the procedure. Then a written report is drawn up. This is either given
to you or sent to the doctor who referred you.
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Preparation
Special preparation is not necessary since no contrast agent is administered.
You do not have to fast beforehand.
The urinary bladder should be emptied before the procedure if possible, and jewellery including piercings within the area of
examination should be removed.
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Precautions
Please also inform the doctor without fail if one of the following applies:
1. Existing or suspected pregnancy. Due to the radiation exposure of the unborn child, an ultrasound is often conducted as
an alternative.
2. Barium-containing contrast agents or bismuth medication within the four days preceding the examination: Limited possibility
for evaluation due to radio-opaque superpositions.
Duration
The entire procedure including preparations takes approximately 5 minutes. As in any medical facility, the start of your procedure
may be delayed if emergency patients have to take precedence. Please always allow enough time.
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Process
The procedure is performed with your upper body undressed. You may be given
a gown to wear. Note that all foreign objects such as piercings must be removed
before the procedure to guarantee optimum image assessment. Metals, for
example, make the evaluation of the image harder or even impossible. You will
be lying on your back on a table while the procedure is performed. A small
lead apron might be placed over the lower pelvis to protect this area from
radiation. Female ovaries cannot be protected as they are located too close to
the abdominal organs being examined. Depending on the diagnostic task, male
testicles can be protected by lead aprons.
During imaging, you will receive the command to briefly hold your breath. Often,
two images are taken: one image while lying on your back, and one image
while standing, in order to detect free air (injury of hollow organs) or an intestine
obstruction (ileus). If an image while standing is not possible, a second image
might be taken lying down, usually with the patient lying on their left side, with
their arms above their head. The examination is not painful. The X-ray table
might be perceived as very hard, and the room temperature may be cool. When
the procedure is over, you can return to the waiting room. It is now evaluated
whether the image is technically sound. The written report of the procedure is
either given to you or to the doctor who referred you.
Radiography of the abdomen
© GH Vienna
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Consideration
Risks
Abdominal radiography uses X-rays. Rays are reduced to a minimum to ensure your safety. There is a low risk of radiation
damage to cells and tissue. With the low radiation doses used, however, the damage is very small compared to the benefits
of the procedure. The radiation exposure corresponds to approximately 1 mSv; this corresponds to a natural environmental
radiation of approximately 3 months. However, since radiation can damage unborn life, the procedure is usually not performed
if you are pregnant.
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Alternatives
An ultrasound examination is a simple, cost-effective, alternative examination to evaluate the abdominal organs. Ultrasound
does not expose the body to X-rays. The detection of an intestine obstruction, free air in the abdominal cavity as well as an
evaluation of the ureters are, however, frequently very difficult or impossible.
Further examinations are, for example: endoscopy (of the stomach and the intestines), examinations of the intestine with contrast
agents, an intravenous pyelography (IVP), a computed tomography or magnetic resonance imaging (cross-sectional images
of all organs).
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FAQ
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Do I have to be an in-patient in the hospital to have an abdominal X-ray?
No, the procedure can be performed if you are an out-patient. You can go home
again afterwards unless there are other medical reasons why you should not
do so.
Which patients should not undergo this procedure?
As a general rule, this procedure is suitable for all patients. However, in
pregnant patients the examination is performed only in exceptional cases for
life-threatening states, provided that an alternative procedure without radiation
exposure is not available or not diagnostically conclusive. When contrast agents
have been administered shortly beforehand, the examination or its diagnostic
conclusiveness has to be considered carefully, and steps towards preparation
may need to be taken.
Is the abdominal X-ray the examination of first choice for acute belly
aches?
Generally, aside from the clinical examination, an ultrasound examination is
initially performed, especially in children and young patients. An abdominal
X-ray is performed additionally or initially only for certain diagnostic tasks. In
some cases, based on the patient’s clinical history, the referring doctor may
also initially ask for imaging cross sections (computed tomography or magnetic
resonance imaging).
Radiography of the abdomen
© GH Vienna
How much radiation will I be exposed to?
The radiation exposure of an abdominal X-ray corresponds to approximately 1
mSv; this corresponds to a natural environmental radiation of approximately 3
months.
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Citations
1 - Team General Hospital Vienna
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