X-ray of the internal organs of the abdominal cavity. X-ray of the abdominal organs. Why do you need an abdominal x-ray and how is it performed. What can be seen in the pictures

It is simply impossible to imagine modern medicine without such a simple and at the same time important industry as radiation diagnostics. The methods of radiation diagnostics include: x-ray, radionuclide, ultrasound, magnetic resonance imaging, thermography, interventional radiology. Each of the methods has its own advantages and disadvantages and is used to diagnose various diseases, either alone or in combination with others.

The ancestor of all radiation diagnostic methods can safely be called radiography. Radiography is a method of X-ray examination, during which an object of interest is visualized on a solid carrier under the influence of X-ray radiation passing through human tissues of various densities and structures.

For almost a hundred years, X-ray images were obtained exclusively on special X-ray films. At the moment, digital imaging methods are actively spreading. With the use of computer technology, they allow you to process, save and instantly transfer high-quality X-ray images to specialists anywhere in the world.

Modern radiography is widely used to examine the musculoskeletal, respiratory, reproductive systems and even abdominal organs.

What is an X-ray examination of the abdominal cavity and its types?

An X-ray examination of the abdominal cavity is a projection of the internal organs, based on the ability of the organs of the human body to reflect X-rays in different ways. That is, X-rays passing from the beam gun of the X-ray machine to a special X-ray film meet an obstacle in the form of a human body. They are reflected from various organs and structures in different ways and therefore reach the film cassette to varying degrees of power, which is what we see in the picture.

How x-rays work

Unfortunately, parenchymal organs do not have the same reflectivity as, for example, bone tissue, so their visualization is much lower. To enhance the image of the organs of interest, special contrast agents are introduced to “illuminate” a person from the inside. On this basis, radiography of the abdominal cavity is divided into survey (without the use of contrast agents) and contrast (with their use).

Contrast radiography of the abdomen

Contrast radiography is actively used to detect pathological narrowing and expansion, ulceration, perforation and tumors of the hollow organs of the digestive tract. For this, barium sulfate powder is used, which does not dissolve in water and human body fluids and at the same time is able to absorb X-rays.

A suspension of barium is taken orally before the study, after which, after certain time intervals, a series of images is taken to visualize the relevant organs and structures. Also, air or nitric oxide is sometimes used as a contrast, which enhances the contrast of organs in x-rays.

Plain radiographic examination of the abdominal cavity

Plain abdominal radiography is a cheap, simple, fast and reliable method for diagnosing a number of surgical diseases. The method allows you to display the state of the main organs of the structures of the abdominal cavity, however, it is indicative.

This means that survey radiography is able to detect predominantly non-specific changes in the body, that is, to find gross violations characteristic of a number of pathologies, to indicate in which organ the problem should be looked for.

To establish a more accurate diagnosis, doctors use other methods. For example, on a survey radiography of the abdominal organs, a dense formation is detected in the projection of the left kidney, and to clarify whether it is calcification or a stone, an ultrasound study is performed. The advantage of the method lies in the breadth of coverage of the area and the possibility of using it everywhere.

Indications

Most often, plain abdominal radiography is performed to diagnose emergency surgical pathology. Usually these are penetrating wounds of the abdomen, intra-abdominal bleeding, intestinal obstruction, abscess formation.

The method is effective for determining dense structures - stones of the kidneys, gall bladder, bladder. In some cases, it is possible to determine the occurrence of tumor processes.

Training

Preparation for a plain radiograph is often not required at all. In some cases, it is recommended to empty the bladder before the procedure. In addition, you need to remove all metal things (belts, chains, metal fasteners) that can cause interference.

Preparation for a contrast examination is a bit more complicated. Before contrast radiography, a special diet is required that excludes foods that increase gas formation in the intestines - cabbage, legumes, black bread.

12 hours before the study, solid food is stopped, and a cleansing enema is performed 1-2 hours before the study. In addition, on the day of the examination, it is recommended to refrain from smoking and chewing gum.

Taking x-rays

An x-ray of the abdominal cavity is performed in a standing or lying position (and sometimes in both positions in succession) on a special couch. The patient is dressed, but all metal objects are removed. The radiologist adjusts the position of the screen to take a targeted picture. The examination takes from one to several minutes, which the subject must hold motionless.

To perform a contrast study, before the procedure, the patient drinks an aqueous suspension of barium sulfate, after which a series of images are taken depending on the organ of interest:

After 1 hour, barium enters the small intestine.
After 3 hours, the transition from the small intestine to the large intestine begins.
After 6 hours enters the colon.
After 9 hours, it passes through the transverse colon.
After 12 hours passes into the sigmoid colon.
After 24 hours, it goes through the rectum.

Detectable pathologies and their radiographic signs

The results of radiographs are evaluated by a radiologist. When evaluating the results of radiography, first of all, the presence of gas in the free abdominal cavity is determined, which is a sign of rupture of a hollow organ.

In the upright position of the patient, the gas is located most highly in the abdominal cavity and can shift with a change in body position. A favorite place for the accumulation of gas bubbles is under the dome of the diaphragm. A large amount of gas can displace internal organs, especially intestinal loops. Reveal pneumoperitonium allows laying the patient on the left side. In this case, the gas collects in a pocket between the liver and the anterior abdominal wall, which is clearly visible on the x-ray.

Free fluid in the abdominal cavity indicates the presence of bleeding due to trauma, tumor, or destructive processes. Unlike air, under the influence of gravity, the fluid flows down and accumulates in the pockets and spaces of the abdominal cavity. Free fluid must be looked for in the space between the colon and the anterior abdominal wall, which is visualized on lateral radiographs as a high-intensity ribbon-like mass.

Calculi are not always shown on abdominal radiographs. An important condition for their visualization is the presence of calcium salts in the composition of the stone. The radiologist indicates their shape, size and relative position with the abdominal organs.

Intestinal obstruction has its own special x-ray sign - Kloiber's cups. They are sections of the intestine, partly filled with liquid, partly with gas. They look like inverted bowls with two-layer contents, which are fixed in the horizontal position of the patient.

The predominance of the vertical size of the “cups” indicates the pathology of the large intestine, but if the horizontal size is increased, this is a sign of small bowel obstruction. Kloiber bowls indicate the neglect of the process.

X-ray of the abdominal organs reveals a liver abscess. Its signs are as follows: limited mobility of the right dome of the diaphragm, an effusion is often found in the right pleural cavity. The mature abscess itself looks like a rounded formation, half filled with liquid, half with gas.

Plain radiography is not a specific method for detecting neoplasms of the abdominal organs, however, in some cases it can detect tumors as small as a few centimeters.

Radiography is often used to detect foreign bodies in the gastrointestinal tract, especially in children who often like to swallow needles, coins, and small toys. However, it should be remembered that not all swallowed objects will reflect X-rays. For example, glass that has entered the gastrointestinal tract is almost impossible to detect.

Contrast radiography allows assessing the patency and degree of narrowing of the gastrointestinal tract, assessing the condition of the walls, in certain situations, identifying neoplasms that compress the walls of the stomach and intestines.

Next steps

The radiologist makes a conclusion based on the obtained radiograph. The attending physician gets acquainted with the results of the examination. On their basis, taking into account the history, examination and laboratory data, he makes a diagnosis and plans further tactics - conservative, surgical treatment, or continuation of the examination by other methods with insufficient information content.

Conclusion

As practice shows, an abdominal x-ray is an important addition to the examination of patients with acute surgical pathology, and it would be a serious mistake not to use it. However, despite the simplicity, speed of obtaining results and the availability of plain radiography of the abdominal cavity, the method also has a number of disadvantages.

Due to radiation exposure, its implementation is highly undesirable for children, pregnant women, patients with diseases of the hematopoietic system. A contrast study is not performed if there is a suspicion of perforation of the stomach or intestines, intestinal obstruction, vomiting, bronchial asthma. In such situations, an ultrasound examination would be a reasonable substitute.

The abdominal cavity is everything that is in the area limited by:

below - the pelvic area;
from above - the sternum;
from the sides - the abdominal muscles;
behind - the spine and back muscles.

X-ray of the abdominal area- This is a study for the diagnosis of the gastrointestinal tract, excretory (liver, mucous membranes, urinary), reproductive system. Assign an x-ray of the abdomen (the second name of the graphic examination of the cavity) for prevention (once every two years or annually for people at risk) and urgent detection of acute conditions.

Appointments and contraindications

Absolute indications for an immediate abdominal x-ray are:

acute abdominal pain;
injuries that could potentially lead to internal hemorrhage;
exacerbation of pathologies localized in the abdominal cavity (ulcers, oncology, cholecystitis, appendicitis, ischemia, stone and kidney disease);
stool with blood;
increased gas exchange for no known reason;
appetite disorders, weight loss / weight gain (sharp, without explanation);
persistent nausea or vomiting.

Do not carry out for children under 12-14 years old, young / expectant mothers (the first 3-5 months after childbirth, with breastfeeding - until the end of lactation). Exceptions are standard: the procedure for instrumental analysis of the abdominal cavity is prescribed in case of a threat to life and in cases where the benefits of the information received may exceed the risks of exposure.

Studies with and without contrast

More often during x-rays, the intestines, stomach and its mucous membranes, and kidneys are examined. It depends on the abdominal organ that is being studied, what kind of x-ray it will be:

with contrast (to study conditions and disorders in tubular organs);
Plain x-ray of the abdominal cavity is performed for urgent diagnosis in order to avoid adverse complications.

A barium-based solution is usually used as contrast for abdominal x-rays. It is recommended to prepare for such a study 2-6 days in advance (scheduled analysis). In preparation for a contrast x-ray, you need to give up food that can increase metabolism, lead to constipation/diarrhea, and increase gas exchange. The taboo list includes everything spicy, fried, salty.

Contrast x-ray of the abdomen can be carried out in dynamics (spot pictures as the solution moves through the channels). The procedure usually takes up to 2 hours. You don't need a hospital after an x-ray.

When is an abdominal x-ray required?

Plain x-ray of the abdomen performed in 35-45 minutes and does not require special preparation. The patient, without taking off his clothes, must fix the body in a comfortable position for the picture.

Usefulness of an overview x-ray of the abdominal region: it allows you to quickly diagnose (start a treatment program) such dangerous pathologies as pancreatitis, intestinal volvulus, obstruction, stones in the bladder or kidneys, ulcer bleeding (stomach / intestines), appendicitis.

Plain x-ray allows you to determine the presence of inflammation, purulent foci, neoplasms, abscesses, gases or fluid in the abdominal cavity. In trauma/mutilation, a plain x-ray helps to diagnose bleeding and prescribe urgent life-saving abdominal surgery.

Contrast X-ray is indispensable for the study of hollow organs. It helps to confirm / refute the presence of oncology, edema, bacterial lesions of the mucous membranes, etc.

Examination of the abdominal organs using X-ray radiation is one of the most informative and popular research methods so far, despite the advent of ultrasound, CT and MRI. The advantages of this method are speed, low cost and relatively low radiation exposure.

Plain radiograph of the ABP

Plain radiography of the abdominal cavity is 150 times safer for humans than, for example, fluoroscopy of the stomach. Therefore, it is this research technique that is used in almost every hospital where there is a gastroenterological department, and even abdominal surgeons cannot think of a case history without several panoramic radiographs of the abdominal organs, performed in dynamics.

Relevance and effectiveness of the methodology

Special requirements are imposed on the qualifications of a radiologist precisely when conducting, interpreting and second reading an overview x-ray of the abdomen. It is much more difficult to make a diagnosis by this type of study than, for example, in the study of the skeleton, where the shadows from the bones are interpreted unambiguously. After all, a competent radiologist should be able to:

to distinguish between the norm and the pathology, which is much more difficult, even if the object is defined;
identify radiological symptoms by analyzing all kinds of characteristics of the shadows of organs, such as their position, number, shape, size, intensity, contours; it is important to be able to determine the displacement of the shadow, which can be shown by fluoroscopy;
determine the leading x-ray syndrome, which allows you to make a diagnosis “immediately”, if any;
make an assumption about the nature of this process.

It is very difficult to do this when performing an x-ray of the abdominal cavity, and the study will be effective only if the radiologist is highly qualified.

How to distinguish between norm and pathology?

Plain radiography of the abdominal cavity - the absence of a gas bubble of the stomach

After all, it is precisely in such a study as radiography of the abdominal organs that it is necessary not only to examine a large number of shadows of hollow organs (stomach, intestines) layered on top of each other, from hollow organs containing liquid, from gas bubbles. Other than that, what does this study show?

Plain x-ray allows you to see the liver and pancreas, the organs lying retroperitoneally - the kidneys and adrenal glands. Shadows from large vessels are guessed, especially if they contain calcifications, and also a shadow from the spine is located along the midline. And only a professional can understand this picture, therefore, it is especially important to observe the strict principle of diagnostic algorithms during this examination.

Indications for research

The scope of indications is extremely wide. These are dynamic disturbances in the passage of barium suspension, the diagnosis of intestinal obstruction, malignant neoplasms of the stomach and intestines, cicatricial stenosis of the esophagus in its burns. In case of gastric cancer, this type of study can even, with a high probability, establish a preliminary type of tumor (plaque-shaped, mushroom-shaped, polyposis, diffuse and other types of cancer).

X-ray of the abdominal cavity with intestinal obstruction

The study is carried out in emergency surgery to study the pathological relief of the mucous membrane (for example, in Menetrier's disease), as well as in the syndrome of stenosis of the alimentary canal throughout its entire length. A study helps to determine the level of damage with a foreign body of the esophagus and stomach.

An X-ray method for examining the abdominal cavity is also used in the dynamic diagnosis of gastric ulcer and duodenal ulcer, with gastroesophageal reflux, cardiospasm and other diseases.

The radiographic research method helps to determine changes in the mucous membrane in gastritis, ulcerative colitis, cancer of the large and small intestine, hemangiomas.

The cheapness and speed of the method make it possible to use it as a screening, before prescribing, for example, an MRI.

Contraindications

There are practically no contraindications to the study, except for the first trimester of pregnancy, as well as ongoing esophageal or gastric bleeding.

Even in an extremely difficult position, the patient can be put for a second to determine the horizontal levels of fluid in the swollen and paretic loops of the intestine, these are the so-called "Cloiber bowls", a pathognomonic symptom of intestinal obstruction.

Horizontal liquid levels with gas bubbles above them - Cloiber bowls

Preparation and methodology

There are several research methods. So, in the study of the organs of the digestive canal, the preparation consists in the introduction of a barium suspension, which can be given orally or retrograde, by filling the large intestine with a barium suspension during irrigoscopy.

When administered orally (through the mouth), barium sulfate is administered to the patient on an empty stomach. It is known that after 9-10 hours barium moves to the ascending colon, and a day later - to the rectum.

In turn, before irrigoscopy, the patient is asked to follow a slag-free diet for 2-3 days, on the eve he is given castor oil and a cleansing enema is performed.

Doctors, depending on the need, prescribe a series of images. Plain radiographic examination of the abdominal organs can be performed without the introduction of barium contrast.

Currently, for the study of lesions of the liver and pancreas, such a study as an X-ray of the abdominal organs is almost never used, since there are MRI, CT and ultrasound techniques.

Previously, radioisotope scintigraphy was used for this, but at present it is almost not performed.

Of the methods of preparing the patient, perhaps, the appointment of a fat-soluble contrast agent in the evening was left, so that it would be absorbed into the bile and contrast the bladder during cholecystography.

Problems in decoding and interpretation

We will not describe in detail all the radiographic symptoms and syndromes of lesions of the intestines, stomach and esophagus. It is known that catalogs of algorithms for lesions of the digestive organs in radiation diagnostics in coloproctology, abdominal surgery and diseases of other organs include tens and hundreds of volumes.

We give only those basic, typical data that form the basis for the formulation of a visual diagnosis. So, for example, when studying diseases of the digestive canal, that is, a tube through which a barium suspension passes, you can get a number of syndromes:

The phenomenon of organ dislocation. For example, the displacement of the stomach by a diaphragmatic hernia, or by a tumor, an aortic aneurysm will be manifested by its displacement.
If a change in the relief of the mucous membrane is detected, a conclusion can be made about the local or general nature of the process, and then, as a clarifying diagnostic method, perform a procedure such as EFGDS (esophagogastroduodenoscopy) or colonoscopy.

FGDS

When a dynamic dysfunction of the alimentary canal is detected, the rate of progress of the contrast suspension on a series of radiographs is assessed, either acceleration or deceleration of the passage of barium is taken as a basis. Dynamic dysfunction is exhibited only in the unconditional absence of organic damage, or "suspicious" shadows.

In conclusion, it can be said that an examination such as X-ray (survey) of the abdominal cavity can, in some cases, make energy-intensive and expensive studies such as computed tomography and magnetic resonance imaging unnecessary, and immediately begin to treat the patient.

Such a diagnostic method of research as radiography has been used in medicine for a long time. Today, thanks to the improvement in equipment quality, image acquisition speed, and the absence of image development, this diagnostic method has become effective, accurate and relatively safe.

Concept and types

The method is named after its inventor (Wilhelm Roentgen) and the Greek. gráphō - food. It refers to non-invasive medical research, and is based on the projection of X-rays onto paper or a special film.

The rays, passing through the anatomical structures of the body, give an image in the form of light-shadow, weakened in those places where the structure of the organ is denser.

In modern devices (digital), the registration of the resulting image can occur on a cassette with a special film or on the matrix of an electronic device. Subsequently, the film can be printed, or the image stored in a database and displayed on the monitor if necessary.

Before proceeding to a detailed study, a survey fluoroscopy of the abdominal and thoracic organs is done. If the survey fluoroscopy cannot give a complete picture of the examination, then they resort to a contrast procedure using a barium mass.

Contrast radiography

In X-ray examination of the gastrointestinal tract, an aqueous suspension of barium is used as a contrast agent. The solution is drunk by the patient or, in some situations, injected through a tube.

Barium is almost insoluble in water and physiological fluids, but has the ability to absorb X-rays, which makes it possible to judge the relief of the mucous membrane

While the barium mass moves through the digestive organs, its progress is monitored using transillumination. In this case, the radiologist examines the function of the intestine and detects the presence of tumors, obstruction or damage.

Overview

Plain radiography allows you to judge the state of the organs adjacent to the esophagus, stomach, and other organs of the gastrointestinal tract.

The abdominal organs have a less dense structure, so the shadow is less pronounced in the picture than the bones. But a review study allows you to see the presence of foreign objects or a change in any organ due to injury or illness.

This examination is prescribed in a complex of other studies to clarify the diagnosis. It takes a few minutes and is quite affordable.

Indications

Diseases that require such a diagnosis:

cholecystitis;
pancreatitis;
soft tissue damage;
abscesses.

This method is used when the patient complains of:

pain, discomfort in the abdomen;
swelling;
heaviness in the digestive system.

With the help of an x-ray examination, the peristalsis and tone of the organ, changes in the relief of the mucosa are clarified. And also the method allows you to determine the level of fluid in hollow organs.

Contraindications

There are practically no contraindications to the study. The disadvantages of this method include:

the impact of ionizing radiation on the patient;
difficult assessment of the functions of the body;

In the study of soft tissues, little different in density, there is insufficient information content without the use of contrast agents.

Training

The examination requires the absence of gases and food, liquid, mucus in the hollow organs.

Before the procedure, the following preparation is carried out:

When examining the liver and gallbladder, radiopaque preparations (Jopagnost, Holevid) are used, which accumulate in the gallbladder and liver. To study the contractility of the gallbladder, choleretic agents can be used.
On the eve of the study of the duodenum and stomach with constipation and severe flatulence, make a cleansing enema and drink 30 g of castor oil.
On the day of the procedure, with severe flatulence, a cleansing enema is also given 2 hours before fluoroscopy. And also with a large amount of mucus, liquid, food residues in the stomach, rinsing is carried out 3 hours before the study.

The study is best done on an empty stomach, having eaten a light dinner the day before. Patients with normal bowel function do not require special preparation in the form of enemas and diets.

How is an abdominal x-ray done?

It is advisable to carry out a diagnostic study in different projections, since the picture is a flat image of a three-dimensional organ, and you need to look at all the walls. Therefore, the study is carried out in different positions of the body.

During the procedure with the use of barium, with the patient in a horizontal position, the movement of the contrast mass slows down, which makes it possible to fill the hollow organ with it, and to take the necessary pictures:

after 1 hour– the contrast mass reaches the small intestine;
3 hours- accumulates in the transition between the small intestine and the large intestine;
6 o'clock- reaches the initial sections of the colon;
9 - colon and transverse intestine;
12 - sigmoid colon;
24 - large intestine.

Price

The radiography procedure is relatively inexpensive and varies depending on the type of examination:

survey radiography - from 350 rubles;
radiography of the stomach - from 750 rubles;
X-ray with barium of the large intestine - from 600 rubles;
small intestine - from 950 rubles;
examination of the esophagus - from 500 rubles;
cholangiopancreatography (examination of the liver and biliary tract) - from 1500 rubles;
irrigoscopy - from 1000 rubles.

What diseases can be detected with an abdominal x-ray?

Where can I get an x-ray of the abdomen?

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

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

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

X-rays with the use of contrast agents are not performed for women during pregnancy. The fact is that the contrast agent has a high risk of causing anomalies in the development of the child. Accumulation of contrast material in fetal tissues may adversely affect 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 all the organs of the fetus are laid. The rest of the pregnancy is an increase in the number of cells and the beginning of their functioning. If possible, x-rays should not be performed at all during pregnancy. During breastfeeding, an X-ray examination of the mother is not contraindicated. X-rays do not affect the composition of breast milk.

For children, an x-ray examination of the abdominal cavity is not recommended. This is due to the fact that the child'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 the age of 18, an abdominal x-ray can be performed without restrictions.

Abdominal x-ray techniques. Preparing for different types of abdominal x-rays

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

Most methods of x-ray examination of the abdominal cavity involve the use of contrast agents. This is due to the fact that soft tissues 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 state of the abdominal organs can be obtained.

There are the following methods of 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 taken? What is used in the course of its implementation?

Abdominal x-rays are a fairly common procedure, although they are not performed as often as bone or lung x-rays. An x-ray of the abdominal cavity is performed in a conventional 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 the harmful effects of 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 unit must meet certain safety parameters. Modern x-ray units are characterized by low x-ray power and, at the same time, good image quality.

The X-ray unit consists of the following elements:

power supply and transformer;
x-ray table;
tripod;
x-ray emitter ( a tube);
focusing device;
X-ray receiver ( sensor or film cassette);
software package for managing and processing images.

Plain x-ray of the abdominal cavity is performed by a radiologist. However, when using contrast techniques, doctors of other specialties, such as surgeons, are sometimes required for research. 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;
pipes and drains;
dressing materials;
devices ( for example, Bobrov's apparatus for irrigoscopy) and other equipment.

A 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 check with your doctor about the specifics of the x-ray study in order to be fully prepared for it.

How is an abdominal x-ray obtained?

Radiography is a method of X-ray examination, in which a static image of certain organs is obtained. An abdominal x-ray is an overview because it displays all the organs of the entire anatomical region. Plain 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.

Abdominal x-rays are taken in the x-ray room in a standing position. Before performing it, you need to undress to the waist and remove all metal objects from yourself. They interfere with x-rays. X-ray of the abdominal cavity is performed only in direct projection. Next, the patient becomes close to the X-ray screen, which contains electronic sensors or X-ray film. The X-ray emitter is installed at the same level with 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, which does not penetrate harmful radiation. The operation of the X-ray unit lasts a few seconds, after which the patient can dress, and the doctor begins to study the image.

For the patient, an abdominal x-ray is absolutely painless. If the patient is unable to maintain a vertical position, they are 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 the data of the survey x-ray of the abdominal cavity.

Method for performing x-rays 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. A barium suspension is used as a contrast agent. It is white in color, firm in texture and tastes like lime. Before the start of 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 of the patient to a vertical position;
taking multiple chest shots for examination of the esophagus) and abdominal cavity;
taking about 600 ml of barium suspension in small sips;
massage ( light pressure) on the top of the abdomen for better filling of the stomach;
taking pictures 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 a barium suspension and gas is used. After the patient drinks the barium suspension, he is additionally given a special powder. As a result of chemical reactions, it leads to gas formation, an increase in the volume of the stomach, and smoothing of wrinkles.

Pictures are taken in a straight line and in a 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 still all this time, being fixed to the examination table. After the procedure is over, you can eat and prepare for other studies, such as barium enema.

Preparing for a Barium Gastrointestinal X-Ray

A barium x-ray of the gastrointestinal tract is not an easy procedure, so proper preparation is essential. It consists in following the rules of nutrition, due to which the formation of gases in the intestines is reduced. In addition, the patient must be aware of the main actions of the doctor during this long study.

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

The patient should take into account that this study may take 2 hours or more, as the images are taken at intervals of 30 minutes. The images are taken in different positions, most of the time the position of the patient 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 feces. The contrast agent may cause unpleasant symptoms such as flatulence, constipation, bloating. When 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 designed to reduce the formation of gas in the stomach. This will ensure a good filling of the stomach and intestines with a contrasting barium mass. A gas-reducing diet is used before most abdominal exams. The exact list of products, as well as the need to comply with it, must be clarified with the attending physician or radiologist.

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

flour products ( bread, buns, pastries);

Preparation for irrigoscopy has its own characteristics. Fecal masses interfere with this examination, so it is necessary to cleanse the intestines in advance with the help of laxatives or enemas. A certain role is played by the observance of a slag-free three-day diet. On the day of the study and 12 hours before the study, you can not eat, it is only allowed to drink water ( up to 1 liter). The scheme of preparation for irrigoscopy should be explained by the radiologist.

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 pictures of the abdominal cavity are performed;
the patient takes a position on his side, puts his hands behind his back and draws his knees to his chest;
in this position, an x-ray contrast agent is injected rectally through a small diameter tube;
barium is injected slowly, as the colon is filled, x-rays are taken;
After the end of the procedure, the patient is escorted to the toilet.

The method of studying the biliary tract using x-rays

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

Cholecystography. It 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 is collected in the gallbladder. In this case, the patient should not eat all the time before the study. The bile ducts in this study are poorly visible. The main application of cholecystography is the detection of gallstones.
Cholegraphy. With this method, a contrast agent is injected intravenously, which allows you to see both the gallbladder and the ducts. 5 - 7 minutes after injection into the blood, the contrast agent begins to fill the biliary tract. Control of the filling of the biliary tract is carried out by a series of x-rays. Cholegraphy also evaluates liver function, the ability of hepatocytes ( liver cells) remove the contrast agent from the blood.
Percutaneous cholangiography. With this method, a 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 bile ducts is determined using x-rays.
Endoscopic retrograde cholangiopancreatography ( ERCP). The contrast agent is injected directly into the bile ducts at their place of entry into the duodenum, under the control of the intra-intestinal fiber chamber. The contrast agent moves in the opposite direction to the flow of bile, so the technique is called retrograde. Using this method, the contrast agent also penetrates into the pancreatic duct. After the injection of a contrast agent, several x-rays of the abdominal cavity are taken.

Method of examination of the urinary tract using x-rays. Excretory urography

Plain x-ray of the kidneys has some features. The patient lies on the x-ray table on his back, hands behind his head. The X-ray emitter is positioned so that it captures the entire abdominal cavity, including the small pelvis. To avoid radiation, the external genital organs are protected with a special screen. During the procedure, a single x-ray is taken. It in itself provides valuable information, allows you to draw up a plan for subsequent research. If necessary, an 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;
renal angiography.

excretory

on the 1st, 5th, 10th, 20th minutes

fabrics

Less commonly used retrograde pyelography. This method examines only the upper urinary tract ( ureter, pelvis and calyx), using the introduction of a contrast agent directly into the ureter. This method is more difficult for the doctor and unpleasant for the patient. It is used when excretory urography was insufficiently informative ( e.g. kidney failure

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