Acute Abdomen Series

Teeranai Sakulchit, MD
Department of Emergency Medicine
Faculty of Medicine
Prince of Songkla University
 Acute Abdomen Series

1. Chest PA
2. Abdomen upright
3. Abdomen supine
Normal Film
 Acute Abdomen Series

• Normal film
– Gas
– Fat
– Soft tissue density
– Calcification
 Normal Film

• Gas
– Stomach
• Air-fluid level
• Left upper quadrant
Stomach

http://www.wikiradiography.com
 Normal Film

• Gas
– Small bowel
• Normally no air
• Diameter < 2.5 – 3 cm
• Location : center of the abdomen
• Valvulae conniventes if dilatation
 Small Bowel

Normal gasless small bowel Normal air-filled small bowel

http://www.wikiradiography.com
 Normal Film

• Gas
– Colon
• Air : normal if diameter < 5
cm
• Location : border of the
abdomen
• Haustration
• Plica semilunaris
• Fecal residue with mottled
appearance

http://www.nlm.nih.gov
Large bowel

http://www.wikiradiography.com
 Normal Film

• Fat
– Properitoneal fat line

http://www.wikiradiography.com
 Normal Film

• Fat
– Psoas sign

http://www.wikiradiography.com
 Normal Film

• Soft tissue density

– Liver
– Spleen
– Kidneys

http://www.wikiradiography.com
Normal Film

http://en.wikipedia.org/wiki/Gallstone
Normal Film

http://en.wikipedia.org/wiki/Gallstone
Normal Film

http://www.aafp.org/afp/2005/0101/p71.html
Pneumoperitoneum
 Pneumoperitoneum

• Chest upright

http://www.rad.msu.edu/education/pages/stu_resources/common/pages/Aben/IM_TUTOR/pages/top10/10.htm
Pneumoperitoneum
• Supine abdomen

http://emedicine.medscape.com/article/372053-overview#a19
 Pneumoperitoneum

• Supine abdomen

http://emedicine.medscape.com/article/372053-overview#a19
 Pneumoperitoneum

• Supine abdomen

http://www.wikiradiography.com/page/Pneumoperitoneum
 Pneumoperitoneum

• Supine abdomen

http://www.sciencedirect.com/science/article/pii/S0735675708002106
 Pneumoperitoneum

• Supine abdomen

http://radiology.rsna.org/content/241/2/623.figures-only
 Pneumoperitoneum

• Supine abdomen

http://emj.bmj.com/content/24/7/518.2.full
 Pneumoperitoneum

• Supine abdomen

http://www.sciencedirect.com/science/article/pii/S0735675708002106
 Pneumoperitoneum

• Supine abdomen

http://emedicine.medscape.com/article/372053-overview#a19
 Pneumoperitoneum

• Supine abdomen

http://emedicine.medscape.com/article/372053-overview#a19
 Pneumoperitoneum

• Left lateral decubitus

http://www.wikiradiography.com/page/Pneumoperitoneum
http://emedicine.medscape.com/article/372053-overview#a01
http://emedicine.medscape.com/article/372053-overview#a01
http://emedicine.medscape.com/article/372053-overview#a01
Dilatation of Bowel
 http://pmj.bmj.com/content/87/1026/274.full
http://www.med.cmu.ac.th/student/rad/wittanee/abdomen/sld097.htm
http://www.medscape.com/content/2004/00/48/28/482837/482837_fig.html
http://quizlet.com/10013333/gi-anatomy-radiology-flash-cards/
http://www.wikiradiography.com/
• Gasless abdomen

http://www.wikiradiography.com
http://www.learningradiology.com
 http://radiopaedia.org
http://www.netterimages.com
 http://radiopaedia.org
http://www.medscape.com/content/2004/00/48/28/482837/482837_fig.html
http://www.acssurgery.com
 http://www.acssurgery.com
http://www.medscape.com/content/2004/00/48/28/482837/482837_fig.html
http://emedicine.medscape.com/article/178948-overview
http://imaging.consult.com