Radiological approach to plain X-ray abdomen

ASCITIS

Feeding tube

• Air :1. Free intraperitoneal air.2. Retroperitoneal air.3. Extraluminal gas

collections.4. Air inside liver.5. Air within bowel wall.

Erect film

Supine film ..Riggler sign

Air under diaphragm- Chilaiditti Syn.

Fundic air bubble

Lesser sac abscess –Acute Pancreatitis

Subphrenic Abscess

Subphrenic abscess

Retroperitoneal air

Pneumobilia-Gall Stone Ileus

Pneumobilia

Portal gas

Emphysematous cholecystitis

Emphysematous cholecystitis

Pneumatosis

Small Intestinal obstruction

Large bowel obstruction

 Small bowel Large bowel

Haustra Absent Present

Valvulae conniventes Present in jejunum Absent

Number of loops Many Few

Distribution of loops Central Peripheral

Radius of curvature of loop Small Large

Diameter of loop 30–50 mm 50 mm+

Solid faeces Absent May be present

Types of colonic obstruction:(A) Large bowel distension only, owing to a competent ileocaecal valve. Caecum at risk of perforation. (B) Large bowel distension and small bowel

distension—a competent ileocaecal valve leads to caecal distension but also acts as a mechanical obstruction to the small bowel. Caecum at risk of perforation. (C) Incompetent

distension, small and large bowel dilatation.

Where is the cause ?

What is the cause ?

Sigmoid volvulus

Cecal volvulus

Bowel wall thickening

Segmental narrowing .Ischaemic colitis

Milk of Calcium

Porcelain Gall Bladder

Gall stones

Different types of gall stones

Gall Stones and chronic Pancreatitis

Pancreatic calcifications

Splenic artery calcifications

Appendicolith

Abdominal aortic aneurysm

Calcified vas

Prostatic calcifications

Calcified fibrois

Bladder calcifications.

Phlebolith

Mass-mesenteric cyst

Lymphomatous masses