PLAIN X-RAY ABDOMEN 65SURGERY-INVESTIGATIONS 3
X-ray chest showing air under the diaphragm(pneumoperitoneum)
usually looked for.The psoas shadows are visible as diverging lineson both sides of spine starting from first lumbar vertebra towards pelvis.The psoas shadows may be obliterated byinflammatory, neoplastic and hemorrhagic(traumatic) lesions of the organ in front and in thevicinity (pancreas, spleen, liver etc.) Ascities or presence of pus in the peritoneal cavityis identified by typical ground glass appearance.It offers valuable diagnostic information.Radio-opaque shadows and calcifications in thefilm are seen and their anatomical correlation isinterpreted.Soft tissue shadows of liver, spleen, kidneys, andpsoas muscle are visible normaly. Outline of urinary bladder, if filled with urine may be seenon plain film.The plain x-ray film of the abdomen showingcomplete urinary system is called KUB film(Kidney, Ureter, Bladder film).
The injuries of abdomen show various radiologicalfeatures depending upon the type, time and siteof injury.The common features seen on plain x-rayabdomen after various type of trauma are:1.Pneumoperitoneum2.Ground glass appearance3.Psoas shadow obliteration4.Sentinel loopsTrauma may be;a.Penetratingb.BluntThe penetrating injuries are usually visible onclinical examination. But the extent of injury maynot be evaluated specifically on clinicalexamination. It presents with pneumoperitoneumon radiological examination in the earlier part.Similarly blunt injuries of abdomen are diagnosedfrom clinical history and examination but extentof injury can only be assessed by variousinvestigations and sometimes even laparoscopyor laparotomy may be required.
Normally no air is present in peritoneal cavity.