![]() Gas and stool outline the ascending and transverse colon ( small arrows ). The most superior collection of intestinal gas is contained in the stomach ( large arrows ). The gas-filled small bowel tends to occupy the central portion of the abdomen and has a smaller caliber than the colon. Rectal gas occupies a midline position in the pelvis and generally extends to the level of the pubic symphysis. The sigmoid colon occupies the inferior aspect of the abdomen and is often recognized by its characteristic shape and haustral folds. Gas in the ascending and descending portions of the colon usually occupies the lateral margins of the peritoneal cavity. Gas may also be seen in the transverse colon immediately inferior to the stomach. The first collection of gas encountered from the top of the radiograph is usually in the antrum and body of the stomach. The normal bowel gas pattern is readily visible on supine abdominal radiographs ( Fig. Radiographic evaluation of intestinal gas should include the following: (1) identification of the bowel segments containing gas (2) assessment of the caliber of these segments (3) assessment of the most distal point of passage of gas and (4) evaluation of the bowel contour outlined by gas. Gas may also be present in the remaining colon, particularly the rectum. In the supine patient, gas rises and accumulates in anteriorly placed segments of intestine, including the antrum and body of the stomach, transverse colon, and sigmoid colon. Intestinal gas has three sources-swallowed air, bacterial production, and diffusion from the blood. The intestinal tract in adults usually contains less than 200 mL of gas. This chapter focuses on the abnormalities of gas and soft tissues that can be detected on abdominal radiographs. Other terms include plain film of the abdomen and abdominal plain film, but with the widespread use of digital imaging and picture archiving communication systems (PACS) for interpretation of the images, abdominal radiograph has become the most appropriate term.Ī wealth of diagnostic information can be obtained from correct interpretation of abdominal radiographs, and several excellent texts are available on the subject. The term flat plate of the abdomen is dated and refers to a time when glass plates were used to produce images. The abdominal radiograph has also been called a KUB- k idneys, u reters (which are not visible), and b ladder. Although CT and ultrasound provide more information about acute abdominal conditions, abdominal radiography has the advantages of relatively low cost and ease of acquisition and can readily be performed on acutely ill or debilitated patients, so it remains a valuable study for the trained and perceptive observer. At 1 year of follow-up, the patient is doing well.Even with the widespread availability of cross-sectional imaging studies, abdominal radiography remains a common imaging test in modern radiology practice. The patient underwent total gastrectomy followed by adjuvant therapy. As part of staging, high-resolution CT scan of abdomen was done which showed the similar lesion in stomach corresponding to CXR findings (Fig. Upper GI endoscopy and biopsy confirmed the finding of advanced proximal gastric adenocarcinoma. A chest X-ray (CXR) was done which surprisingly revealed an irregular, funnel shaped, soft tissue opacity in cardia and fundus of stomach suggesting a mass lesion in stomach (Fig. Liver function and renal function tests were within normal limits. Blood investigations showed haemoglobin of 6.0 g/dl. On physical and abdominal examination, there were no significant findings other than pallor. She denies any history of pain abdomen, early satiety or loss of weight. She has undergone 3 pints of blood transfusion for chronic iron deficiency anaemia. A 60-year-old lady with a known case of diabetes mellitus presented with complaints of episodic black coloured stool, malaise and dizziness for 3 months duration. ![]()
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