The abdominal x-ray is a test that can be carried out quickly and easily in an emergency department. The test can rule out major illnesses such as a small or large bowel obstruction, quickly and effectively. It is a useful test in a practise called differential diagnosis. For example, a patient who presents with right sided abdominal pain is most likely to be suffering from appendicitis. To prove this, you would have to prove that the patient did not have an intestinal obstruction or something similar, which could cause the pain. Once an obstruction is ruled out by a clear x-ray, the doctor could then follow a different line tests to give an accurate diagnosis.
An abdominal x-ray is usually taken with the patient lying in a supine position. Depending on the pathology in question the x-ray can also be taken with the patient lying prone, in a decubitus position or even erect. Coverage on the x-ray should include from the top of the Liver (or diaphragm) to the Symphysis pubis. The abdominal organs included on the xray (although not visible) are the liver, spleen, stomach, intestines, pancreas, kidneys, bladder and reproductive organs.
In an acute setting the abdominal x-ray is used to diagnose:
- Bowel obstruction
- Bowel perforation although this is more commonly diagnosed by a Chest x-ray
- Kidney stones or Gall stones Further tests are then used to confirm this diagnosis.
- Faecal impaction