Radiography of Abdomen: Essentials

Abdominal Radiography

Abdomen Basic Anatomy

The digestive system consist of the alimentarty tract and certain organs that contribute to the digestive process. The teeth is the most important accessory organs of the digestive systems in radiology, because it use to masticate the food. Furthermore, salivary glands has also an important role in masticating by secreting fluid that helps soften the food. As the food swallowed the liver and pancreas secretes an especial digestive juices into the small intestine.

What is Peritoneum?

The peritoneum is an abdominopelvic cavity that is enclosed in a doulble-walled seromenbranous sac. There are two sac in the peritoneum. The outer sac which is in the outer surface called the parietal peritoneum, and it is close in contact with the abdominal wall. And the vinceral peritoneum that is positioned around the contained organs and forms a fold called the mesentery and omenta, which supports the viscera in position. There is a space in between the two layers of the peritoneum that called peritoneal cavity and contains serous fluid. These two are not attach and pelvic surgery is possible without entering in the peritoneal cavity. Retroperitoneum Cavity It is the cavity behind the peritoneum, Kidneys and panceas are located in the retroperitoum.

Radiographic Examinations of Abdomen:

These Projection are frequently performed in the United States and Canada. Students should be competently knowledgeable with these projections.

Routine Preliminary Preparations:

In radiology, investigating the abdominal viscera, preliminary preparation of the intestinal tract is essential. These preparations are the combination of Laxative, controlled diet also known as the Nothing per Orum (NPO), and enemas are done to a non severe conditions. Although majority of the patients who is referred for the abdominal examination are well enough to undergo these routine preparation. These routine preliminary preparation is never administered to patients who are acutely ill or have the condition such as visceral rupture or intestinal obstruction or perforation. As for these patients, referring physician is consulted as to the presumptive diagnosis, and the procedure is varied as needed.

Exposure Technique Tips for an Abdominal Radiography:

Plain abdominal examination, without the use of contrast media, it is imperative to obtain maximum soft tissue diffentiation of radiograph throughout the different regions of the abdomen. Because abdomen has a wide range in the thickness and delicate diffenrence in physical density between the contained viscera, radiologic technologist must select for a more critical exposure factors than the normal to demonstrate the diffenrece in density between an opacified organ and the structures near to it. Radiograph with moderate gray tones and less black and white contrast is needed. If the kilovolt-peak (kVp) is too high, demonstrating small or semiopaque gallstones may not be visualized. The criteria for an optimal quality abdominal radiograph is when outlines of the psoas muscles, the lower border of the liver, the kidneys, ribs, and the tranvese processes of the lumbar vertebrae are sharply defined.

Proper Abdominal Radiograph

Controlling Motion: Voluntary and Involuntary

The primary requirements to achieve good radiographic images of the abdomen is to eliminate motion both voluntary and involuntary. Voluntary motion produces a blurred outline of the structures, that do not have involuntary movements, such as the liver, psoas muscles and the spine. Involuntary motion in the abdomen like the peristalsis, may produce either a localized or generalized haziness radiographic image. Meanwhile, Contraction of the abdominal wall or the muscles around the spine may cause movement of the whole abdominal area and create a generalized radiographic haziness. These can be minimized or eliminated by the following steps:

Place the patient in a comfortable position so that he or she is relax, this will prevent the contraction of the muscle that caused by tenseness of patients.
Breathing procedure must be explained to patient, and make sure he or she understand exactly what is expected.
Compression band may be use if needed, for immobilization but not compression.
When making the exposure, do not trigger the exposure 1 to 2 seconds after the suspension of respiration to allow the patient to come to rest and the involuntary movement of the viscera is subsided.