Abdominal organs x-ray is a method of contrast-free X-ray diagnostics of the condition of the abdominal cavity. It is informative for judging the presence of fluid, free gas, and foreign bodies in the abdominal cavity. According to survey radiographs, perforations and ruptures of hollow organs are diagnosed (by the presence of free gas), intestinal obstruction (by the presence of Cloiber cups – swollen intestinal loops with gas and liquid levels), bile and urolithiasis (by the presence of concretions in the gallbladder or kidneys), ascites (by the presence of effusion).
In clinical practice, overview and X-ray contrast examination of abdominal organs is used in gastroenterology, abdominal surgery and urology. Overview abdominal organs x-ray is prescribed for acute abdominal and lumbar pain, abdominal distension, suspected intestinal obstruction (with malignant and benign tumors, inflammatory diseases, etc.), diverticulitis, intestinal intussusception, rupture of a hollow or parenchymal organ, cholecystitis, pancreatitis, cholelithiasis and urolithiasis.
Contrast radiography of the abdominal organs is performed after performing a survey image confirming the integrity of the hollow organs (in order to avoid throwing barium into the abdominal cavity). Indications for the study are suspicion of the presence of neoplasms, diverticula or stenosis of the hollow organ. Based on the data of the survey and contrast radiography, a treatment plan is drawn up, additional examinations are prescribed (if necessary) or a decision is made on surgical intervention.
Overview and contrast abdominal organs x-ray is not recommended during pregnancy and at the age of 14 years. As an exception, situations are considered when the study is carried out for vital indications (for abdominal injuries and acute abdomen). In other cases, other techniques are used: ultrasound of the abdominal cavity, MSCT of the abdominal cavity, MRI of the liver, MRI of the pancreas, etc.
Contraindications to contrast radiography are hypersensitivity to contrast media, perforation of the hollow organ, acute diverticulitis, ulcerative colitis during exacerbation, severe dehydration, intestinal obstruction (prevents the excretion of barium with feces), mixed and intestinal forms of cystic fibrosis. Alternatively, ultrasound or MSCT of the abdominal organs, colonoscopy, laparoscopy and other studies can be prescribed. The decision on the need for radiography is made individually, taking into account the severity of the pathology and the risks associated with the study.
Special preparation for the survey study is not required. Before starting the procedure, the bladder should be emptied. Before contrast radiography, it is necessary to refrain from eating rye bread, vegetables and dairy products during the day and from eating solid food for 12 hours. Before irrigoscopy the night before and 1-1.5 hours before the procedure, the colon should be cleaned using an enema or laxative.
In the study of the upper gastrointestinal tract, the contrast agent is administered orally or through a probe, in the study of the lower intestine – with an enema. Overview radiography of the abdominal organs is performed in a standing position (in a lying position, gas and liquid will be distributed throughout the abdominal cavity, and their levels will not be visible), contrast radiography – in a standing or lying position, in several projections. Then the radiologist describes the images and passes them along with the description to the attending physician. Sometimes the results are given to the patient’s hands (for example, when referring for a consultation to another clinic).
Interpretation of results
In acute intestinal obstruction, an overview radiograph reveals “inverted bowls” (gas accumulations above the liquid), a large amount of gas and transverse striation. With ascites and bleeding in the abdominal cavity, a horizontal fluid level is visible. Foreign bodies are displayed in the images as shadows. The color and saturation of the shadow depend on the density of the object: the higher the density– the lighter the shadow. Kidney and gallbladder stones containing calcium salts are also light inclusions. Based on the X-ray data of the abdominal organs, the doctor can determine the size, shape and location of foreign bodies and concretions. By studying the images using a contrast agent, it is possible to make a conclusion about the state of the intestinal mucosa, the presence of narrowing areas and tumor-like formations, to assess the extent and severity of narrowing areas, the contours of tumors and ulcers, etc.