Background
Abdominal radiographs play a fundamental role in the assessment of patients presenting with abdominal pain. Inexpensive, fast, and widely available, abdominal radiographs aid in diagnosing abdominal pathologies, identifying the need for further imaging, and guiding clinical decision-making. Despite the inherent limitations of abdominal radiographs, plain films can provide invaluable information in the evaluation of both acute and chronic abdominal pain. For example, analysis of bowel gas patterns can reveal bowel obstructions, evidence of ischemia, or visceral perforation. Findings related to solid organ, soft tissue, or vascular pathologies may also be detected on plain film, thereby assisting in making the correct diagnosis.
Educational Goals / Teaching Points
This pictorial review will cover a variety of pathologies in emergency and inpatient hospital settings, as well as provide key teaching points that residents and learners can employ when interpreting abdominal radiographs. The exhibit will review the importance of abdominal radiographs, as well as their indications and limitations. Proper radiographic technique, projections, and patient factors will be discussed. Uses for enteric contrast medium will be reviewed. Finally, an approach to interpreting an abdominal radiograph will be provided. By reviewing a multitude of cases, the goal of the exhibit is to highlight key radiographic findings and tips when interpreting radiographs to ensure the correct diagnosis is made, or further imaging is suggested when applicable.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
At a cursory glance, radiographs are limited with regard to the densities and silhouettes that can be observed to demarcate different tissues. However, this imaging modality can still provide a wealth of information and yield more clues than may initially be apparent. We will aim to cover common diagnoses not to be missed. As well, we will provide cases that demonstrate more subtle findings which may guide the radiologist/clinician to less common diagnoses. Various pathologies will be reviewed, with multimodality correlation to further characterize the findings when available.
Conclusion
Despite its limitations, abdominal radiography remains a valuable tool in the assessment of abdominal pain. When utilized appropriately, radiographs can help to triage the undifferentiated patient and expedite diagnoses. Although commonly utilized to evaluate bowel gas patterns, we demonstrate how abdominal radiographs can reveal pathology beyond bowel. An approach to interpreting abdominal radiographs is provided, with tips to ensure the correct diagnosis is made.
