The regions of the kidneys, bladder, and ureters are of great functional and pathological significance. In a supine and flat position, an abdominal X-ray views the abdominal and urinary areas in an anteroposterior projection.
Indications for this X-ray include symptoms such as:
Abdominal pain, swelling, or cramps
Any ongoing nausea or vomiting, diarrhea, or constipation
Any colic, flank, or back pain
Ingestion of any foreign body
Abnormal fullness or bloating
Any feeling of urinary obstruction like delayed or slow urination or pain while passing urine
Contraindications for this X-ray include: This is not advisable for pregnant women or those suspected to be pregnant unless necessary because it can lead to radiation exposure to the mother and the fetus. It is not indicated in a patient on any bismuth medications such as Pepto-Bismol or has had a barium contrast within the last few days. The patient should mention the placement of an intrauterine device.
This X-ray utilizes radiation, and hence there is always a low risk of radiation exposure while taking it. Proper protection and care must be taken to minimize this risk.
Radiographic Signs and Diagnoses
Normal imaging will show the normal shape and size of abdominal and urological organs such as intestines, kidneys, urinary bladder, and ureters without any masses, fluid or gas accumulation, or obstructions. Signs of abnormal X-ray include step ladder appearance, coil spring, a string of pearls, slit or stretching, crescent or closed-loop signs, paucity, radio opacities, bubbles, and many more signs.
This X-ray is helpful to detect and diagnose abnormalities such as:
Radiopaque calcifications in kidneys, ureter, or bladder in case of renal calculi, nephrolithiasis, or urolithiasis. It images stone presentation and characteristics such as stone size, shape, location, and any structural obstruction from the stone.
Any organomegaly, renal hematomas or masses, congenital renal anomalies, hydronephrosis, or bladder distention
Bowel gas pattern, fluid accumulation, or obstruction
Ascites, hemorrhage, perforation or abscess, paralytic ileus, masses, ruptured organ, tumor in the intestines
Any obstruction in the flow of urine through the ureters from ureteral stones or strictures
Trauma or visceral injury to liver, spleen, kidney, bladder
Vascular calcifications, ischemic bowel
Intestinal or bowel obstruction
Procedures Involving Flat Plate of the Abdomen Radiograph
This procedure is a non-interventional radiographic procedure with a low risk of radiation exposure. This concise and easy procedure does not cause any severe side effects or complications and does not require much pre or post-procedural management. Before X-ray filming, any jewelry, objects, or clothing worn by the patient should be removed. The patient should be draped in the hospital gown. Any contraindicating conditions must be mentioned before the X-ray.
After draping in a gown, the patient lies flat and supine on the X-ray table, holding the hands straight at the sides. Leg support can be provided if needed.
Care is taken to position the abdomen between the X-ray machine and the X-ray cassette.
The regions which need not be imaged are covered with a lead apron or shield to protect from radiations.
The radiographic projection should be anteroposterior (AP) with a centering point at the midsagittal plane at the iliac crest level.
The patient should hold the flat position throughout the imaging process because any movement will distort the image. This is because the X-ray beam will target the area in focus to image the parts viewed.
The radiologic technician should stay in the protective window after setting the patient for the X-ray.
Factors that may interfere with the x-ray results can be any jewelry or metallic objects worn by the patient, non-cooperation by the patient to maintain the position, movement while filming the X-ray, improper positioning of the patient, improper alignment or functioning of the equipment.
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