Description result x-ray obp review conclusion. Survey radiographic examination of the abdominal organs: an old technique, indispensable in modern medicine

It is generally accepted that a diagnostic method such as radiography is used primarily for the purpose of examining hard tissues. Indeed, the most common indications for this procedure are injuries, fractures, and dislocations. But quite often patients are prescribed What does this research method show, how to prepare correctly and does it have serious contraindications?

Why are x-rays done?

This instrumental procedure refers to methods radiology diagnostics, which is in demand in modern medicine. The principle of radiographic examination is to study the condition internal organs and tissues by passing X-rays through them. Based on the results of the diagnostics, doctors can assess the morphological and functional changes inside the body and detect foreign bodies and neoplasms.

Brief history of radiography

The technique owes its name to the inventor who managed to project gamma radiation onto paper. Later, they began to use a special film on which the image was clearer. This non-invasive study is one of the oldest techniques in the history of medical diagnostics.

What does an abdominal x-ray show? Radiation, passing through internal organs and tissues, displays the picture in the form of chiaroscuro. In places where the image turns out to be pale, a conclusion is drawn about a denser structure. Today, radiographic images are stored on digital or matrix media, which allows the image to be displayed on a computer monitor or printed for detailed study.

Typically, X-rays of the abdominal cavity are done without the use of a contrast agent. This type of research is called review. If it does not allow an objective assessment of the condition of the patient’s internal organs, they resort to repeated radiography, but with the use of barium sulfate.

Study with contrast

Chemical compound, which allows you to get a clearer picture of the examination, give the patient a drink immediately before starting diagnostic procedure. An aqueous suspension of barium can be administered through a probe if the subject is not able to take it on his own.

What does a barium x-ray of the abdomen show? This element is practically insoluble in water and biological fluids of the body, but at the same time it has the property of powerful absorption of gamma radiation, thanks to which the doctor will be able to draw conclusions about the relief of the mucous membranes of the internal organs.

Specialists carefully monitor how the contrast agent moves through the patient's digestive system. Areas in which barium mass accumulates glow and are easily visualized, which allows the radiologist to study the functionality of the esophagus, stomach, intestines, and detect tumors, obstructions or damage.

Survey diagnostics

This X-ray examination method is intended to study the condition of the gastrointestinal tract and systems adjacent to the esophagus. A survey X-ray of the abdominal cavity is most often prescribed to children if there is a suspicion of the presence of foreign objects in the stomach. As a rule, it is recommended to carry it out in combination with other instrumental and laboratory procedures for staging accurate diagnosis.

Since the abdominal organs have a loose structure, the shadow in the image is less pronounced than that of the bones. Compared to a contrast study, a survey image is less informative and can detect only a tenth of what an abdominal x-ray with barium shows. At the same time, this type of examination is quite sufficient to determine in a few minutes and without prior preparation a patient’s organ injury or detect a foreign body in the cavity.

What is the difference between fluoroscopy and radiography

X-ray, as an instrumental research procedure, cannot replace other diagnostic methods, but supplements them with objective information, and, therefore, contributes to the rapid and accurate determination of the disease. Today, doctors equally often resort to using both diagnostic methods. What's the difference?

  • Radiography makes it possible to see changes in organs in images displayed on photosensitive film.
  • Fluoroscopy is a type of diagnosis that is performed in real time. The picture is displayed on the screen.

What does an abdominal x-ray show?

From the school anatomy course we know that the abdominal cavity is a space delimited on the sides by the abdominal muscles, the lumbar muscles - in the back, and in the front - by the peritoneum. In the lower part of the abdominal cavity are located the iliac pelvic bones, and on top is the diaphragm. The digestive and genitourinary systems are located in this part of the body. The first includes the stomach, esophagus, large and small intestines, liver, pancreas and gall bladder, the second includes the internal genital organs, bladder, kidneys, etc.

Knowing what an abdominal x-ray shows, you can see a real picture of the functionality of the internal organs, including determining:

  • Are gases and liquids distributed normally?
  • are there any accidentally swallowed objects or kidney stones in the gastrointestinal tract? gallbladder;
  • whether internal bleeding has occurred;
  • is there any damage to organs?

Who needs an x-ray

This type diagnosis is prescribed by a specialist, as a rule, in one case - if the patient complains of severe abdominal pain. This syndrome may indicate the presence of pathologies such as:

  • spicy and chronic pancreatitis;
  • inflammation of the gallbladder and cholelithiasis;
  • malignant and benign formations;
  • intestinal obstruction;
  • pyelonephritis and glomerulonephritis;
  • intestinal diverticulitis;
  • inflammation of appendicitis;
  • serious injuries, internal bleeding.

Patients admitted to emergency department hospitals due to acute pain, they first take an overview x-ray of the abdominal cavity. What does this type of diagnosis show and how informative is it? Typically, plain radiography is enough to get a general idea of ​​the patient’s condition in a matter of minutes and draw up a plan for further action.

How does the procedure itself work?

The examination can be carried out in any position convenient for the patient. In some cases, an image of the abdominal organs in several projections is required, so pictures can be taken standing or lying down. You do not need to remove your clothing before taking an X-ray of your abdomen, but you should be sure to remove any metal objects from the X-rays.

The patient is placed nearby and the specialist determines the optimal position of the device according to the height of the person being examined. You cannot move during the procedure. Otherwise, the examination picture will be blurry and you will have to undergo the examination again.

An image and description of the abdominal x-ray are given to the patient immediately after the procedure. The conclusion is made by a radiologist, and the diagnosis is made by the specialist who issued the referral for this procedure. To avoid increased radiation exposure, it is not recommended to undergo radiography more than once every six months.

Methods of preparation

Patient who needs urgent diagnostics, does not undergo any specific training. If the examination was planned in advance, you will have to first devote time to cleansing the intestinal tract. On the eve of the study, the patient needs to have an enema or take the laxative “Fortrans”. Knowing what an x-ray of the abdominal cavity shows in adults and how it reflects the picture of the examination, it is important to prevent extraneous shadows that will introduce errors in the conclusion.

If the patient suffers from severe flatulence or has a tendency to constipation, for three days before the appointed date of the study he should adhere to light diet menu. During this period, it is advisable to completely eliminate products that contribute to gas formation:

  • legumes;
  • dairy products;
  • rye bread.

Preparing for an abdominal x-ray also means avoiding pasta and meat. You cannot eat food on the day of the examination. During the diet, it is advisable to take sorbents that will help the body cleanse itself faster and more effectively.

What can you see in the photographs

As for the description of the images, it is worth immediately noting that the initial results must be assessed by a radiologist. If the patient was admitted by emergency care after injury or exposure to other factors, first of all, doctors must exclude the possibility internal bleeding, rupture of a hollow organ, which may be indicated by the presence of gases in atypical places. Hemorrhage is usually indicated by the presence of free fluid in the lower abdomen. U healthy person it shouldn't be there.

In addition, using X-rays, specialists can diagnose:

  • pneumoperitoneum (pathological filling of the abdominal cavity with gas);
  • the presence of stones in the gall bladder (stones are extremely rarely displayed on the projection, which, according to experts, depends on the location of the formations, their size, shape);
  • intestinal obstruction (in this case, individual fragments of the intestine will resemble large dilated bowls containing a lot of gas and liquids);
  • (this diagnosis is made by doctors when there are significant restrictions in the mobility of the diaphragmatic dome and when effusion appears at the location of the right pleural cavity);
  • neoplasms, various foreign bodies that enter the body through the esophagus.

Some products, particularly those that are commonly swallowed by children, do not reflect X-rays and may not be visible in photographs. If pancreatitis is suspected, it is recommended to undergo an x-ray abdominal organs.

Compared to plain radiography, contrast radiography is considered more informative, as it allows you to detect even subtle nuances, for example, the degree of patency in any part of the gastrointestinal tract. With the help of barium mass it is much easier to analyze the condition of the mucous membrane of internal organs, confirm or exclude the presence of tumors. X-rays can detect a neoplasm in the abdominal cavity only when it is already compressing the walls neighboring organs.

Where to get an abdominal x-ray

This study is carried out on the basis of a referral from the attending physician. Any of the highly specialized specialists - therapist, gastroenterologist, urologist, nephrologist, endocrinologist - can prescribe an x-ray. The cost of the procedure may vary slightly depending on the medical institutions, depending on the form of ownership, the technical capabilities of the available equipment, and the qualifications of the radiologist. You can take an x-ray as in paid clinic, and in the budget. The main thing is that a qualified radiologist draws up a detailed and reliable report. The cost of diagnostics usually includes interpretation of the image.

  • What diseases can be detected using an abdominal x-ray?
  • Where can I get an abdominal x-ray?

  • The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

    X-ray examination. What is an abdominal x-ray?

    X-ray examination ( x-ray) is perhaps the most known method diagnostics X-rays were discovered back in 1895, and in 1901 a prize was awarded for the use of X-rays in medicine. Nobel Prize their discoverer, Wilhelm Conrad Roentgen. Most people are familiar with x-rays, since this method is performed for almost any limb injuries, fractures, and lung diseases. However, few people know that x-rays are also an effective diagnostic method for the abdominal organs.

    X-rays using contrast agents are not performed on women during pregnancy. The fact is that the contrast agent has high risk cause developmental abnormalities in the child. The accumulation of contrast agent in fetal tissues can have an adverse effect on their development.

    Abdominal X-ray for children and pregnant women

    X-ray examination for women is absolutely contraindicated during the first trimester of pregnancy. This is the period when the formation of all fetal organs occurs. During the remainder of pregnancy, the cells increase in number and begin to function. If possible X-ray examination should not be performed at all during pregnancy. During breastfeeding, X-ray examination of the mother is not contraindicated. X-rays do not affect the composition of breast milk.

    For children, X-ray examination of the abdominal cavity is not recommended. This is due to the fact that children's body is in a state of growth and, accordingly, is more susceptible to ionizing radiation. This is also due to the fact that X-rays of the abdominal cavity usually require a higher dose of radiation than, for example, X-rays of the extremities. After reaching 18 years of age, abdominal x-rays can be performed without restrictions.

    Techniques for performing abdominal x-rays. Preparing for different types of abdominal x-rays

    The abdominal cavity is an anatomically important area in which large number vital organs. Currently, there are a variety of methods for studying them. X-ray examination is only one of the branches of radiation diagnostics, and special areas can also be distinguished in it.

    Most abdominal x-ray examinations involve the use of contrast agents. This is due to the fact that soft fabrics on x-rays do not have sufficient contrast and partially merge into the general background. Depending on the method of administration and the composition of the contrast agent, unique data on the condition of the abdominal organs can be obtained.

    Highlight following methods X-ray examination of the abdominal cavity:

    • plain X-ray of the abdominal cavity;
    • X-ray of the gastrointestinal tract with barium contrast;
    • cholegraphy;
    • endoscopic retrograde cholecystopancreatography ( ERCP);
    • angiography;
    • excretory urography and others.

    Where is an abdominal x-ray performed? What is used during its execution?

    An X-ray of the abdomen is a fairly common procedure, although it is not performed as often as X-rays of the bones or lungs. An abdominal x-ray is performed in a regular x-ray room. Such rooms can be found in every clinic or diagnostic center. X-ray rooms have special anti-radiation protection, which is aimed at reducing harmful effects X-rays. The main equipment of the X-ray room is the X-ray unit. The X-ray machine is a high-tech device. It is used repeatedly to examine patients, so the X-ray machine must meet certain safety parameters. Modern X-ray machines are different low level power of X-ray radiation and, at the same time, good quality images.

    The X-ray installation consists of the following elements:

    • power supply and transformer;
    • x-ray table;
    • tripod;
    • x-ray emitter ( tube);
    • focusing device;
    • X-ray receiver ( sensor or film cassette);
    • software package for image management and processing.
    A survey x-ray of the abdominal cavity is performed by a radiologist. However, when contrast techniques are used for research, doctors of other specialties, for example, surgeons, are sometimes required. To perform contrast techniques in the X-ray room, special equipment must be prepared.

    During special x-ray techniques, the following substances and equipment can be used:

    • contrast agents of various chemical compositions;
    • catheters;
    • surgical needles, syringes;
    • scalpels;
    • endoscopes;
    • tubes and drains;
    • dressings;
    • devices ( for example, Bobrov’s apparatus for irrigoscopy) and other equipment.
    The variety of techniques for x-ray examination of the abdominal cavity should not confuse the patient. X-rays should only be performed for certain indications, as X-rays are not completely safe. Indications for x-ray examination are determined by the attending physician. Before undergoing any type of abdominal x-ray, you should find out from your attending physician the specifics of the x-ray examination in order to be fully prepared for it.

    How is a plain abdominal x-ray obtained?

    Radiography is a method x-ray examination, which produces a static image of certain organs. An abdominal x-ray is a survey because it shows all the organs of an entire anatomical region. A survey X-ray of the abdominal cavity serves as the first study, thanks to which most diagnoses are eliminated and a plan for further research is drawn up.

    An abdominal x-ray is taken in a standing position in an x-ray room. Before performing it, you need to undress to the waist and remove all metal objects. They interfere with the X-ray image. An X-ray of the abdominal cavity is performed only in a direct projection. Next, the patient stands close to the X-ray screen, which contains electronic sensors or X-ray film. The X-ray emitter is installed at the same level as the patient’s abdomen, horizontally to the floor, at a distance of 1.5 to 2 meters. The doctor controls the X-ray unit remotely from a special room into which harmful radiation does not penetrate. The operation of the X-ray unit lasts a few seconds, after which the patient can get dressed, and the doctor begins to study the image.

    For the patient, a plain X-ray of the abdominal cavity is absolutely painless. If the patient cannot maintain an upright position, he is x-rayed in a horizontal position, lying on the x-ray table. If necessary, after a survey x-ray, special techniques are performed using contrast agents. To clarify the indications for them, doctors use data from a plain X-ray of the abdominal cavity.

    Method of performing an X-ray of the stomach and small intestine with barium

    Contrast X-ray techniques involve taking pictures of the gastrointestinal tract after they are filled with a contrast agent. X-rays using a contrast agent take a long time. This is due to the fact that it takes a certain time for the contrast agent to pass through the gastrointestinal tract. Barium suspension is used as a contrast agent. She has white, dense consistency and taste similar to lime. Before starting the study, the patient must undress to the waist.

    X-ray of the stomach and intestines with barium includes the following steps:

    • fixing the patient to the table in a horizontal position;
    • transfer the patient to a vertical position;
    • taking several chest pictures ( for examination of the esophagus) and abdominal cavity;
    • taking about 600 ml of barium suspension in small sips;
    • massage ( light pressure) on the upper abdomen for better filling of the stomach;
    • taking photographs of the chest and abdomen at short intervals ( up to 30 minutes) and in different positions.
    Sometimes, for x-ray examination, a double contrast technique with barium suspension and gas is used. After the patient drinks the barium suspension, he is additionally given a special powder. As a result chemical reactions it leads to gas formation, an increase in the volume of the stomach, and smoothing out folds.

    Pictures are taken in direct and lateral projection, both standing and lying down. The time between doing them can be filled with discussion or reading a book. However, the patient must remain motionless all this time, being fixed to the examination table. After the procedure is completed, you can eat and prepare for other studies, for example, irrigoscopy.

    Preparing for a barium x-ray of the gastrointestinal tract

    X-ray of the gastrointestinal tract with barium is a complex procedure, so proper preparation is extremely important. It consists of following nutritional rules, which reduce the formation of gases in the intestines. In addition, the patient must be aware of the basic actions of the physician during this lengthy study.

    Two to three days before the test you should switch to a slag-free diet. The last meal before an abdominal x-ray should be 10–12 hours before. It is also prohibited to smoke or drink alcohol during this time. During this period, you cannot take drugs that regulate the activity of the gastrointestinal tract to ensure the objectivity of the study. It is better to come to the X-ray room without jewelry or metal objects. You should take a book with you to fill the waiting time between scans, as well as food so you don't go hungry after the exam.

    The patient must take into account that this study may take 2 hours or more as pictures are taken at 30 minute intervals. The images are taken in different positions, most of the time the patient's position will be fixed on the table. Sometimes the doctor will press on the abdomen to better distribute the barium suspension. After the study, the contrast agent will leave the gastrointestinal tract for about 3 days, discoloring the stool. The contrast agent may cause unpleasant symptoms such as flatulence, constipation, bloating. If they appear, you should immediately consult a doctor.

    What should be the diet before an abdominal x-ray?

    The diet before an abdominal x-ray is aimed at reducing the formation of gases in the stomach. This will ensure good filling of the stomach and intestines with the contrast barium mass. A diet that reduces gas formation is used before most abdominal examination techniques. The exact list of products, as well as the need to comply with it, should be clarified with your doctor or radiologist.

    The diet before an abdominal x-ray excludes the following foods:

    • flour products ( bread, buns, pastry);
    • through the rectum). The need for such a supply of contrast agent is explained by the fact that the normal passage of the contrast agent through the stomach and intestines requires about 10 hours. Irrigoscopy allows you to study the wall of the colon along almost its entire length, to identify inflammatory diseases, polyps or colon cancer.

      Preparation for irrigoscopy has its own characteristics. Feces interfere this survey Therefore, it is necessary to cleanse the intestines in advance using laxatives or an enema. Following a slag-free three-day diet also plays a certain role. On the day of the examination and 12 hours before the examination, you cannot eat food, you are only allowed to drink water ( up to 1 liter). The radiologist should explain the preparation plan for irrigoscopy.

      The technique of irrigoscopy consists of the following steps:

      • in the X-ray room, the patient undresses and lies down on the table to take pictures;
      • Several survey images of the abdominal cavity are taken;
      • the patient takes a position on his side, puts his hands behind his back and draws his knees to his chest;
      • in this position, the X-ray contrast agent is administered rectally through a small diameter tube;
      • barium is injected slowly, and X-rays are taken as the colon fills;
      • After the procedure is completed, the patient is escorted to the toilet.
      The preparation and procedure of such a study are considered inconvenient and poorly tolerated by patients. After the contrast agent is injected, you may experience pain and a desire to have a bowel movement. After irrigoscopy, bed rest for several days is recommended. However, her diagnostic value exceeds the possible inconveniences of the technique. An alternative to barium enema is magnetic resonance imaging or endoscopy.

      Method for studying the biliary tract using x-rays

      The study of the bile ducts is carried out exclusively with the help of contrast agents, since the walls of the bile ducts are completely transparent x-rays and are not visible on x-ray film. There are various techniques injection of contrast agents, and the closer to the bile ducts they are introduced, the more accurate the results. But at the same time, the risk of complications increases and side effects diagnostic procedures.

      The following methods of X-ray diagnostics of the biliary tract using a contrast agent are distinguished:

      • Cholecystography. This is a study of the gallbladder. The day before the study, the patient takes an iodine-containing contrast agent. During the night, it enters the bile, which collects in the gallbladder. In this case, the patient should not eat food all the time before the study. The bile ducts are poorly visible during this study. The main application of cholecystography is to identify gallstones.
      • Holegraphy. With this method, a contrast agent is injected intravenously, which allows you to see both the gallbladder and ducts. 5 - 7 minutes after injection into the blood, the contrast agent begins to fill the bile ducts. Filling control biliary tract carried out in a series x-rays. Using cholegraphy, liver function and the ability of hepatocytes ( liver cells) remove contrast agent from the blood.
      • Percutaneous cholangiography. With this method, the contrast agent is injected directly into the bile ducts using a special needle that pierces the skin and liver. The condition of the lumen of the biliary tract is determined using x-rays.
      • Endoscopic retrograde cholangiopancreatography ( ERCP). The contrast agent is injected directly into the bile ducts at their confluence with the duodenum, under the control of the intestinal fiber chamber. The contrast agent moves in the direction opposite to the flow of bile, which is why the technique is called retrograde. Using this method, the contrast agent penetrates into the pancreatic duct. After the contrast agent is injected, several x-rays of the abdominal cavity are taken.
      Techniques associated with intravenous or intrahepatic administration of a contrast agent are to a certain extent dangerous for humans and are recommended for use only if ultrasound examination turned out to be ineffective. Complications of cholecystography include bleeding, heaviness in the abdomen, pain, and allergies to the contrast agent.

      Technique for examining the urinary tract using x-rays. Excretory urography

      The kidneys can be examined using a plain abdominal x-ray. In this case, they are visualized in natural contrast, which, unfortunately, does not always give accurate results. The contours and tissue of the kidneys can be seen on a survey x-ray of the abdominal cavity in 60–70% of cases. However, this method is indicated if stones, calcifications or foreign bodies in the kidneys are suspected and urinary tract because they have high contrast.

      A survey x-ray of the kidneys has some peculiarities. The patient lies on the X-ray table on his back, placing his hands behind his head. The X-ray emitter is positioned so that it covers the entire abdominal cavity, including the pelvis. To avoid radiation exposure, the external genitalia are protected with a special shield. During the procedure, only one x-ray. It in itself provides valuable information and allows you to draw up a plan for subsequent research. If necessary, x-ray examination of the kidneys is supplemented with the use of contrast agents.

      There are various methods of x-ray examination of the kidneys:

      • plain radiograph of the kidneys;
      • excretory urography;
      • retrograde pyelography;
      • angiography of the kidneys.
      Contrast X-ray examination is performed only if necessary. The most common method contrast study kidney is excretory ( excretory) or intravenous urography. With this method, 40–50 ml of a radiopaque substance containing iodine is injected intravenously. It is quickly excreted with the kidneys, briefly increasing their contrast on x-rays. A series of x-rays are taken ( at 1st, 5th, 10th, 20th minutes). Using this method, you can examine both the state of the parenchyma ( fabrics) kidneys and their functional activity. After the kidneys, the contrast agent ends up in the ureter and bladder, which, if necessary, makes it possible to see these organs on an x-ray.

      Retrograde pyelography is less commonly used. With this method, only the upper urinary tract is examined ( ureter, pelvis and renal calyces), using the injection of a contrast agent directly into the ureter. This method is more difficult for the doctor and unpleasant for the patient. It is used in cases where excretory urography was not informative enough ( for example, in renal failure

    • X-ray of the abdominal cavity. X-ray picture of healthy abdominal organs. X-ray methods in the diagnosis of diseases of the abdominal organs

    Abdominal X-ray is one of the most common methods for diagnosing diseases of the gastrointestinal tract. It is this method of examination that is used primarily in the hospital when a patient is admitted with complaints of abdominal pain, flatulence, and bowel dysfunction.

    The essence of radiography

    X-ray is one of the most ancient methods of visualizing internal organs. The essence of its work is the passage of X-rays through internal organs. Since radiation easily passes through the intestinal tube and is weakly reflected from the intestinal wall, survey radiography of the abdominal organs is in many cases uninformative.

    However, the speed of obtaining results, the low cost of this method, and the absence of the need for high-tech equipment make x-rays quite common for emergency diagnostics diseases of internal organs. In addition to this, there are a number radiological symptoms that cannot be seen using other examination methods. Namely, the presence of these symptoms is decisive in some pathologies.

    What a normal x-ray should look like can be seen in the figure below.

    Types of radiography

    There are two types of examination of the abdominal organs using X-rays: contrast and plain radiography of the abdominal cavity.

    The introduction of contrast during the procedure significantly increases its information content and diagnostic value. The contrast for the intestines is a barium solution. The patient drinks a glass of this substance (100 ml of water per 80 g of barium), and then a series of photographs are taken over the course of an hour. If the study is carried out to diagnose rectal pathology, the solution is administered using an enema. It consists of 720 g of barium and 1 liter of 0.5% tannin solution. This contrast agent is not absorbed into the blood and is excreted along with feces.

    The radiologist observes how barium passes through the intestines, how the loops of the intestinal tube are filled, and after what time the barium is evacuated from different departments. This allows you to visualize how structural changes intestines, and disruption of its motor function.

    What does an x-ray show?

    As noted above, survey x-rays are not very informative, but are extremely common. Then what does a plain radiography of the abdominal cavity show?

    • The presence of gas and liquid in the abdominal cavity.
    • Presence foreign bodies.
    • Defects of the abdominal organs.
    • Is there any traffic obstruction? feces in the intestines.
    • Is there internal bleeding?

    Thus, when answering the question of what an abdominal x-ray shows, it is worth saying that it only reflects the presence of some pathology in the body. But to make an accurate diagnosis, additional examination is often necessary.

    Indications for plain radiography

    Despite the minimal radiation dose during x-rays, there is still radiation exposure. That's why this method diagnostics are carried out only with the direction of a doctor. He, in turn, can write out a referral for a plain radiography of the abdominal cavity, subject to the presence of the following symptoms and conditions:

    • acute abdominal syndrome - sharp pains in the stomach;
    • flatulence;
    • abdominal organ injuries;
    • Diverticulitis is a protrusion of the intestinal wall with inflammation.

    Although X-rays are rarely the gold standard for diagnosing abdominal disease, they are often the first method used. Using radiography of the abdominal organs, you can suspect the presence of the following diseases:

    • acute intestinal obstruction;
    • perforated stomach or intestinal ulcer;
    • acute cholecystitis;
    • acute pancreatitis;
    • cholelithiasis and urolithiasis;
    • abscesses (purulent cavities) of internal organs.

    Preparing for X-rays

    No specific preparation is required for plain abdominal radiography. It is only recommended to empty your bladder before the examination.

    But preparation for an abdominal X-ray with barium takes place. To ensure that the examination is informative and to avoid complications, you must adhere to a number of rules:

    • do not eat solid food 12 hours before the examination;
    • avoid consumption per day raw vegetables, black bread, lactic acid products, as they enhance intestinal motility;
    • an hour or two before the x-ray, bowel movements are performed using an enema or suppositories with a laxative;
    • Immediately before the examination, you need to remove all metal objects.

    A separate method of preparation for x-rays using the drug “Fortans” is distinguished. The sachet dissolves in one glass of water. The dosage prescribed by the doctor is drunk in the evening before the examination, one sachet every hour.

    How is an X-ray performed?

    A survey radiography of the abdominal cavity is done in two projections: lying and standing. Most often, the first option is omitted and X-rays are taken only while standing; this method is more informative. This allows for better visualization of intestinal obstruction, as well as perforation or perforation of ulcers.

    Contrast radiography is more difficult. Here it is necessary to take a series of pictures after a certain time and observe how the barium solution moves through the intestines. This process of moving barium is called passage.

    The location of barium as a function of time is as follows:

    • after 1 hour - the contrast is partially in the stomach, partially in the small intestine;
    • after 3 hours - the contrast should completely leave the stomach and fill the small intestine;
    • after 6 hours - contrast in primary departments large intestine (cecum and ascending colon);
    • after 9 hours - contrast in the transverse and descending colon;
    • after 12 hours - contrast in the descending colon and sigmoid colon;
    • after 24 hours - contrast in the rectum.

    Contraindications to radiography

    Diagnosis using x-rays should only be carried out with the direction of the attending physician. After all, only a qualified specialist can comprehensively assess the patient’s condition and find out whether he has contraindications to abdominal radiography.

    All contraindications can be divided into absolute (in which it is strictly forbidden to conduct research) and relative (it is permitted only in extreme cases, When possible risk less than the intended benefit).

    Listed below are only the most basic conditions that are a contraindication to any x-ray diagnostics, not just the abdominal cavity:

    • pregnancy, especially the first half, since during this period the formation of the child’s organs occurs;
    • serious condition a patient in whom it is impossible to transport him to the X-ray room;
    • open pneumothorax - a pathology in which air from environment enters the pleural cavity located around the lungs;
    • bleeding.

    Contraindications to contrast radiography

    X-rays using contrast are contraindicated in the following cases:

    Also, the procedure cannot be performed on women during lactation.

    Intestinal obstruction: X-ray signs

    Among the pathologies of the intestinal tube, X-ray has received the greatest diagnostic value. Quick results and the presence of symptoms characteristic of obstruction enable the surgeon to establish a diagnosis and carry out immediate surgical intervention.

    In case of obstruction, a survey radiography is performed vertical position. Characteristic is an increase in the airiness of the intestinal tube, which indicates excessive accumulation of gas in the intestines.

    The most academic symptom is the presence of fluid levels, the so-called Kloyberg cups. Moreover, by the shape and location of these cups, the level of pathology can be determined. If the cups are high and narrow and are located on the periphery of the x-ray, we can talk about the presence of obstruction in the large intestine. Surgeons also use the term "low obstruction."

    If the Kleuberg bowls are low and wide, and also placed closer to the center, this indicates a subtle intestinal obstruction, or high. Also characteristic is the expansion of the intestine to the site of the obstruction and the collapse of the intestinal section after.

    When performing contrast radiography, you can notice that the evacuation of barium is slow or absent altogether.

    In some cases, radiography allows one to visualize the obstacle itself (tumor, intestinal torsion, adhesions).

    Obstruction of the small and large intestine: differences

    When diagnosing obstruction, it is important to distinguish in which part of the intestine the problem arose: in the small or large intestine. In addition to the difference in the location and shape of the Kloyberg bowls, there are a number of other features.

    If it is not clear enough from the bowls which department is involved in pathological process, you can do a contrast X-ray of the abdominal cavity. In this case, distended intestinal loops are clearly visualized.

    Signs of obstruction small intestine:

    • swollen loops occupy predominantly the center of the image;
    • they do not exceed 4-8 cm in size;
    • characterized by the presence of transverse striations against the background of swollen loops;
    • there are no specific concavities along the edges (haustra).

    Signs of large intestinal obstruction:

    • swollen loops of larger diameter;
    • there are concavities - haustra;
    • characterized by the presence of arched folds (symptom of arches).

    Thus, the value of abdominal radiography in diagnosing obstruction is extremely high. However, there are times when X-ray picture unclear. Then it is necessary to carry out other examination methods: ultrasound, computed tomography.

    Perforated ulcer: X-ray signs

    A perforated (perforated) ulcer is a rupture of the wall of the stomach or intestine, which is accompanied by severe, dagger-like pain.

    When ruptured, air enters the abdominal cavity and rises upward to the diaphragm. Since the liver is located on the right under the diaphragm, the accumulation of air is best seen between these two organs. It collects there in the form of a thin arc-shaped strip. This phenomenon is called crescent air in abdominal radiography.

    This symptom is most typical for perforation of an ulcer, however, other signs can be identified on x-ray:

    • the presence of a gas bubble that moves when the body position changes;
    • displacement of the sickle of air under the sternum when the patient turns on his side;
    • if gas is not detected on the first image, the patient is given sparkling water to drink; the gas will escape through the resulting hole and will be visible on an x-ray;
    • if the diagnosis is unclear, contrasting is possible, but not with barium, but with gastrografin; the substance will exit through an opening in the hollow organ.

    It can be concluded that radiography of the abdominal organs is a truly effective method for initial stages diagnosis of a number of pathologies of the abdominal organs. And if you suspect intestinal obstruction and perforated ulcer his role is simply invaluable.

    X-ray of the abdominal organs- projection images of internal organs (stomach, small and large intestines, gall bladder and bile ducts, etc.). When examining the abdominal cavity, survey and targeted images in standard or additional projections are used. Plain radiography can detect free gas and fluid in the abdominal cavity, stones in the gall bladder and urinary tract, tumors, and signs of intestinal obstruction. Since hollow organs do not reflect X-rays, their examination is carried out after preliminary contrast. Contrast types of radiography include esophagography, gastrography, cholecystography, cholangiography, enterography, irrigography, etc. The cost varies depending on the type of study, the need for use and the type of contrast agent.

    Indications

    IN clinical practice Survey and X-ray contrast examination of the abdominal organs is used in gastroenterology, abdominal surgery and urology. Survey radiography abdominal cavity is prescribed for acute pain in the abdomen and lumbar region, bloating, suspected intestinal obstruction (for malignant and benign tumors, inflammatory diseases, etc.), diverticulitis, intussusception, rupture of a hollow or parenchymal organ, cholecystitis, pancreatitis, cholelithiasis and urolithiasis.

    Contrast radiography of the abdominal organs is carried out after taking a survey image confirming the integrity of the hollow organs (to avoid barium reflux into the abdominal cavity). Indications for the study are suspicion of the presence of a neoplasm, diverticulum or stenosis of a hollow organ. Based on the data from plain and contrast radiography, a treatment plan is drawn up and prescribed additional examinations(if necessary) or decide to undergo surgical intervention.

    Contraindications

    Contraindications to contrast radiography are: increased sensitivity to a contrast agent, perforation of a hollow organ, acute diverticulitis, ulcerative colitis during an exacerbation, severe dehydration, intestinal obstruction (prevents the excretion of barium with feces), mixed and intestinal form cystic fibrosis. Alternatively, ultrasound or MSCT of the abdominal organs, colonoscopy, laparoscopy and other studies may 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.

    Preparation

    No special preparation is required for the survey study. Before starting the procedure, you should empty your bladder. Before contrast radiography, it is necessary to refrain from eating rye bread, vegetables and dairy products for 24 hours and from eating solid food for 12 hours. Before irrigoscopy the night before and 1-1.5 hours before the procedure, you should cleanse the large intestine using an enema or laxative.

    When researching upper sections in the gastrointestinal tract, the contrast agent is administered orally or through a probe; when examining the lower intestines, using an enema. A survey 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 is performed in a standing or lying position, in several projections. The radiologist then describes the images and passes them along with the description to the attending physician. Sometimes the results are given to the patient (for example, when referred for a consultation to another clinic).

    Interpretation of results

    In case of acute intestinal obstruction plain radiograph“inverted bowls” (accumulations of gas above the liquid), a large amount of gas and transverse striations are detected. With ascites and bleeding in the abdominal cavity, a horizontal level of fluid is visible. Foreign bodies appear as shadows on images. The color and saturation of the shadow depend on the density of the object: the higher the density, the lighter the shadow. Kidney and gallstones containing calcium salts are also light-colored inclusions. Based on abdominal x-ray data, the doctor can determine the size, shape and location of foreign bodies and stones. By studying images using a contrast agent, one can draw a conclusion about the condition of the intestinal mucosa, the presence of areas of narrowing and tumor-like formations, assess the extent and severity of areas of narrowing, the contours of tumors and ulcers, etc.

    Abdominal X-ray is one of the traditional non-invasive diagnostic methods in modern medicine.

    Thanks to the local exposure to safe levels of X-ray radiation, it makes it possible to obtain a projection image of the internal structures of the human body.

    This method, when used correctly, is considered not dangerous to the life and health of the patient, and the research procedure is simple and comfortable.

    Radiography takes literally a few minutes. The procedure may require preparation.

    What can be seen on an X-ray examination?

    The most popular types of X-ray examination today are general X-ray examination of the abdominal cavity and contrast radiography.

    Plain X-ray makes it possible to evaluate general condition internal organs located in the abdominal cavity.

    A plain X-ray will help you see the following types pathologies:

    • the presence of pathological neoplasms (hematomas, cysts, polyps or tumors, sometimes stones) in the tissues and cavities of the kidneys, gall or bladder;
    • mechanical violations of the integrity of the abdominal organs (ruptures);
    • the presence of gas or liquid in the gastrointestinal tract or generally within the abdominal cavity;
    • pathological accumulations of feces and gas in the intestines (for example, with intestinal obstruction).

    This method is used to clarify the diagnosis. It is often prescribed in conjunction with a group of other studies, and if a survey examination cannot answer the specialists’ questions, then they resort to x-rays with contrast.

    Contrast X-rays are performed using a special substance that fills organ cavities that are not visible with a plain X-ray.

    Before similar procedure you need to take a drug containing barium orally (in some situations it is administered through a tube).

    Barium sulfate, used in contrast radiography, is slightly soluble in water and physiological fluids, but at the same time it absorbs X-rays.

    The drug with barium is not absorbed in the digestive tract and does not change its properties under the influence of secretion from the digestive organs. It is eliminated from the body during defecation with feces.

    Examination with contrast allows you to examine in detail possible pathological changes mucous tissues of the gastrointestinal tract. An X-ray with barium will show ulcerations, perforations, narrowing of the lumen of hollow organs, tumors.

    Who is conducting the research and why?

    The use of a survey x-ray is necessary when:

    • the patient is tortured painful sensations in the stomach and lower back;
    • bloating often occurs;
    • there are suspicions of internal organ injuries or the development of a retroperitoneal abscess;
    • in the formation of acute intestinal obstruction due to the appearance of neoplasms (cysts, tumors or polyps) or intussusception;
    • there are signs of diverticulitis.

    Plain X-rays are also used to diagnose organ inflammation. digestive system, detection of stones in the bladder or kidneys.

    It is this type of radiography that shows perforation and violations of the integrity of the tissues of not only the intestines, but also other organs of the abdominal cavity.

    There are very few contraindications for conducting a survey examination.

    Except that any X-ray examination is not recommended for women during pregnancy and children under 14 years of age. Ultrasound is recommended as an alternative to x-rays in these cases.

    But, as already written above, the survey method does not show the structural features of the hollow organs of the gastrointestinal tract. For this purpose, a contrast study is used.

    Thanks to the contrast agent, the specialist obtains an image of all folds and bends digestive tract, can reveal changes in the structure of their tissues.

    The contrast method of research with barium has its own characteristics. It will not be used in cases where the patient has allergic reaction to contrast components.

    This type of X-ray examination is not used in cases of dehydration, intestinal symptoms with vomiting and diarrhea or cystic fibrosis.

    In some cases, perforation of the digestive tract, obstruction and diverticulitis in acute phases may also be contraindications.

    Sometimes at the discretion of the doctor (when the threat to health is higher than the diagnostic value of the study) with similar symptoms the examination is carried out using other methods.

    How to properly prepare for the procedure?

    No special preparation is required before a survey of the abdominal cavity. The only requirement is that you empty your bladder before taking the x-ray.

    This type of examination can be carried out with clothes on, but jewelry must be removed.

    The procedure can be performed either lying down or standing. During the study, the patient stands or lies down for several minutes.

    Sometimes x-rays are taken in different positions to obtain more information. The patient must remain motionless during the examination.

    Special preparation will be required for examinations using contrast agents. You must stop eating at least 12 hours before the procedure.

    Within a day or even two, you should start following a diet that excludes all vegetables, rye bread, milk and cream from your diet.

    This is necessary so that the image is as clear as possible and the organs are clearly visible.

    Preparing the gastrointestinal tract for the study can be done directly on the day of the procedure or the night before.

    Preparing for x-ray examination on the day of diagnosis involves the use of an enema or special rectal suppository with a laxative effect. The procedure is recommended to be carried out one and a half to two hours before the examination.

    However, it is worth considering the characteristics of your body. For some people laxative effect lasts longer than others.

    In such cases, you need to calculate the time in advance so that the intestines have time to cleanse themselves and the urge to defecate does not interfere with the procedure.

    Preparation on the eve of the study will make it possible to avoid discomfort directly on the day of diagnosis and guarantees a good cleansing effect.

    To prepare in advance, they usually use one of the simplest and most modern methods of colon cleansing at home.

    Today the easiest way is to clean it yourself lower sections gastric tract using lavage agents. For this, Fortrans, Lavacol, Fleet Phospho-Soda or Endofalk are used.

    Lavage preparations are a mixture of minerals that are not absorbed in the intestines. When a person drinks such a solution, the liquid with minerals diluted in it passes through the gastrointestinal tract directly, clearing all the folds.

    The product must be taken in accordance with the instructions supplied with it. The drugs begin to be used after the last meal.

    From there until the time of x-ray, it is worth maintaining a period of fasting so that the gastrointestinal tract is clearly visible. Before an x-ray using contrast, the patient must drink a drug containing barium.

    X-ray examination of the abdominal cavity is a proven highly effective non-invasive diagnostic method, allowing a specialist to identify the slightest pathological changes in the structures of internal organs quickly and with comfort for the patient.