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 belongs to the methods of radiation diagnostics, which are in demand in modern medicine. The principle of radiographic examination is to study the condition of 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 test 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

A chemical compound that allows you to get a clearer picture of the examination is given to the patient to drink immediately before the start of the 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 to make an 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 complements 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 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, kidney stones or gall bladder stones in the gastrointestinal tract;
• whether internal bleeding has occurred;
• is there any damage to organs?

Who needs an x-ray

This type of 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:

• acute 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 the hospital emergency department because of acute pain are first given a plain X-ray of the abdomen. 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

A patient who needs urgent diagnosis does not undergo any specific preparation. 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 is prone to constipation, he should follow a light diet menu for three days before the scheduled test date. 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 evaluated by a radiologist. If a patient is admitted to emergency care after being injured or exposed to other factors, first of all, doctors must exclude the possibility of 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. A healthy person shouldn't have it 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 of the 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 tumor in the abdominal cavity only when it is already compressing the walls of 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 in different medical institutions, depending on the form of ownership, the technical capabilities of the available equipment, and the qualifications of the radiologist. You can get an x-ray done both in a paid clinic and in a budget one. 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.

X-rays are actively used to diagnose diseases of the abdominal organs. Plain radiography of the abdominal cavity is widely used - an X-ray examination without the introduction of a contrast agent, which allows one to obtain a general picture of the condition of the abdominal cavity.

Abdominal organs: general information

The abdominal cavity is the abdominal cavity, which is limited above by the diaphragm, in front by the abdominal wall, behind by the lumbar spine, on the sides by the abdominal muscles, below by the ilia and the pelvic diaphragm. Inside the abdominal cavity are the organs of the digestive system - the stomach, gall bladder, liver, intestines, pancreas, as well as the spleen and organs of the urinary system - kidneys and ureters.

Examination of the pancreas, gallbladder, liver and spleen is usually carried out using methods that turn out to be the most informative for these organs. To examine the remaining organs of the abdominal cavity, predominantly other diagnostic methods are used, including radiography.

What does an abdominal x-ray show?

The method is based on the fact that tissues of different densities absorb X-rays differently. Denser, for example, bone tissue transmits rays less well, so such tissue appears lighter in the picture. The method allows you to determine the location of organs, their integrity, the presence of foreign bodies and neoplasms.

An abdominal x-ray shows:

• how gas and liquid are distributed in the abdominal cavity, whether there is free fluid in the abdominal cavity;
• whether there are foreign bodies in the abdominal cavity (swallowed objects in the intestines, gallstones, kidney stones);
• whether there is damage to internal organs;
• whether there is intra-abdominal bleeding.

From the point of view of assessing the condition of specific organs, plain radiography of the abdominal cavity is not very informative, but it allows you to quickly determine whether the picture is pathological or not. If the wall of the stomach or intestines ruptures (perforation of an ulcer or destruction of the wall by a tumor), an x-ray will show gas escaping into the free abdominal cavity. Using an abdominal x-ray, you can diagnose intestinal obstruction and even determine the approximate location of the problem.

When is an abdominal x-ray prescribed?

A survey radiography of the abdominal cavity is prescribed if there are severe complaints. Similar pain can occur with the following diseases:

• appendicitis;
• abscesses and inflammatory diseases of the abdominal organs;
• tumor processes;
• intestinal ischemia;
• intestinal obstruction;
• intestinal volvulus.

Plain radiography of the abdominal cavity is also prescribed for abdominal injuries.

How is an abdominal x-ray performed?

No special preparation is required for a plain abdominal x-ray.

Radiography can be performed in both one and two projections (in standing and lying positions). Sometimes it is enough to take an X-ray only in a standing position (this position allows you to better localize the problem of intestinal obstruction, as well as see a perforation of the stomach or intestines).

Before the examination, it is necessary to remove metal objects (jewelry). There is no need to take off your clothes. During the x-ray, you will need to stand still for some time, and hold your breath while the picture is taken.

The abdominal cavity contains many vital organs, problems with which require complex diagnostics. One of the effective and affordable methods for detecting diseases of the abdominal organs is x-ray.

What is an abdominal x-ray?

An abdominal x-ray is a non-invasive, completely painless method of medical examination using x-rays. Modern X-rays allow you to project images of internal organs clearly and with the least harm to the body. An X-ray of the abdominal cavity shows the position of the internal organs, as well as their structure and tone. The examination is carried out by a radiologist who monitors the correctness of the process. He also gives the patient a conclusion with the diagnostic results, which then must be shown to the doctor. Despite the high information content of modern x-ray research methods, a correct diagnosis requires an examination by a doctor, tests, etc. As a rule, x-rays are the final stage in drawing up a complete clinical picture.

Types of abdominal x-ray

The close arrangement of organs in the abdominal region causes difficulties during examination, which forced the improvement of diagnostic methods. Modern radiography of the abdominal cavity can be performed in two ways, each of which has indications and advantages.

Survey study

This is a standard diagnostic method, the most accessible and simple. A plain X-ray of the abdomen shows what is causing the discomfort and discomfort: excess gas or fluid, bleeding, or foreign objects (such as kidney stones or small objects swallowed). Also, a survey X-ray of the abdominal organs allows you to see damage that has arisen for various reasons: from inflammation to injury.

Contrast study

Contrast x-ray of the abdominal organs is an improved research method that allows you to obtain a more detailed description of the condition of any organ. In this case, barium sulfate is used as a contrast agent, which stains the blood vessels from the inside and makes the pattern of the internal organs clearer.

Indications for the study

An abdominal x-ray is a serious examination that is prescribed by a doctor only if necessary. If there are certain indications and the results of other studies, radiography will help confirm or refute the suspected diagnosis.

Pain in the abdomen (acute abdomen syndrome) and lower back pain

Pain in the abdomen and lower back can be a symptom of many diseases: inflammation of the appendix, cholecystitis, acute pancreatitis, ectopic pregnancy, etc. An X-ray of the abdominal cavity, which shows the structure of the internal organs, allows us to identify an inflamed or damaged organ that is the cause of acute abdominal syndrome. Typically, an X-ray of the abdominal cavity for acute abdominal syndrome is prescribed in particularly difficult cases when making a diagnosis is difficult due to concomitant health problems.

Bloating

Typically, bloating occurs due to improper diet, however, if it is observed constantly, an x-ray of the abdominal cavity may be prescribed, which shows structural abnormalities of the organs. The cause of bloating can be inflammatory diseases of internal organs, as well as neoplasms and swelling. All these problems are clearly visible on a contrast radiograph.

Abdominal injuries

An X-ray of the abdominal cavity is indicated if internal injuries are suspected, since violation of the integrity of any organ can lead to disastrous consequences. Damage is indicated by free gas, which is visible on x-rays to varying degrees, depending on the organ. Plain radiography also allows you to see bleeding or hematomas.

Retroperitoneal abscess

A retroperitoneal abscess is the appearance of purulent formations on internal organs. This disease can occur due to trauma, abdominal surgery, organ perforation, or the growth of metastases. The consequence of a retroperitoneal abscess can be sepsis and, as a consequence, death. An X-ray of the abdominal cavity can reveal the position of the abscess and its size. As a rule, it is prescribed after an ultrasound if necessary.

Acute intestinal obstruction

Since in case of acute intestinal obstruction, areas of the intestine with liquid and gas are visible in a horizontal position of the patient, an X-ray of the abdominal cavity is taken in a supine position. The shape and size of these areas determines in which part of the intestine the obstruction is located. The most effective in this case is a contrast X-ray of the abdominal cavity. Acute intestinal obstruction can be fatal if untreated, so correct diagnosis in this case is extremely important.

Intussusception

The cause of the development of acute intestinal obstruction can be intussusception - the introduction of one section of the intestine into another. Pathology can have consequences in the form of the development of inflammatory and tumor processes. The causes of intussusception are very diverse, and X-ray examination helps to understand them. For this purpose, a survey radiography of the abdominal cavity or a more informative one, contrast, is used. In a particularly difficult case, an additional computed tomography may be prescribed, which is also a type of radiation diagnostics.

Preparing for an abdominal x-ray

Plain radiography of the abdominal cavity does not require any preparation. However, for a contrast X-ray of the abdominal cavity, preparation is required, since if there are remains of food, liquids or gases inside the organs, their condition will be difficult to determine. 2-3 days before the test you will need to follow a diet, giving preference to foods that do not cause gas. 12 hours before the x-ray you will need to stop eating solid food, and it is advisable to cleanse your intestines two hours before. Also, a few hours before the test, the patient is given a barium sulfate solution to drink to stain the organs.

How is an X-ray performed?

Immediately before the test, your doctor will ask you to remove items from your pockets that may interfere with the image being displayed on the screen. An x-ray of the abdominal cavity is taken in both vertical and horizontal positions. In some cases, it may be necessary to scan the body in two projections in order to better see the condition and structure of the internal organs. The patient takes a standing or lying position. In order for the pictures to be of high quality, it is necessary to remain still.

Contraindications to X-rays

Contrast and plain radiography of the abdominal cavity is a relatively safe method of examination, but has contraindications. Radiation diagnostics is contraindicated for children under 15 years of age and pregnant women; obstacles may also arise if the patient’s condition is inadequate or severe, when it is impossible to remain still. In general, thanks to radioprotection methods, modern radiation is harmless to humans even when carried out regularly.

X-ray of the abdominal organs allows us to identify a wide range of pathologies . Includes examination of the following organs: liver, stomach, intestines, pancreas, ureter, lymphatic system, gall bladder and blood vessels.

If there are indications for the procedure, the patient can go to the clinic at his place of residence or to a private clinic with a convenient location, modern equipment and experienced radiologists. The most effective is an examination with the introduction of a contrast agent.

What does it show?

• genetic developmental abnormalities;
• oncological diseases of various internal organs;
• abnormal accumulations of fluids;
• abscesses in the retroperitoneal space;
• blocked intestinal lumens as a result of the formation of polyps and cysts of different sizes;
• causes of acute abdominal syndrome;
• stones in the liver and kidneys;
• inflamed areas in the intestines;
• foci of infection in the pancreas;
• consequences of abdominal and spinal injuries;
• intussusception;
• gallbladder pathology.

Indications and contraindications

Among the main reasons to prescribe an abdominal x-ray to a patient are:

• Previously diagnosed cholelithiasis.
• Pronounced signs of cholecystitis.
• Excessively enlarged abdomen.
• Recent injuries.
• Suspicion of inflammation of appendicitis.
• Germination of one part of the intestine into another.
• Ischemic disease of the colon.
• Diverticulitis.
• Progressive intestinal obstruction.
• Palpable lumps and neoplasms in the peritoneal area.

Despite the effectiveness of the method for primary and differential diagnosis, X-rays should not be taken for pregnant and nursing mothers, children under 14 years of age, as well as patients with severe chronic pathologies of internal organs.

Contraindications for contrast radiography are:

• cystic fibrosis;
• bronchial asthma;
• prolonged diarrhea and/or vomiting;
• acute phase of ulcerative colitis;
• perforation of the gastrointestinal tract.

What is plain abdominal radiography?

Targeted diagnostics is practiced with confirmed pathology of a specific organ, and to assess the condition of the abdominal cavity as a whole, a survey x-ray is required.

It is especially useful in the presence of perforated areas, allowing you to identify free gas and find where the intestinal wall has ruptured. In addition, it is prescribed to assess the prevalence of large tumors and determine the degree of intestinal obstruction.

Patients with suspected or already diagnosed pancreatitis, cholecystitis, nephrolithiasis, diverticulitis, and severe pain are referred for a contrast study.

How to prepare?

Before going for an x-ray, you should get individual preparation recommendations from your attending physician. If a contrast agent will not be administered, then no special preliminary measures are needed. The only caveat is that you need to come to the procedure after emptying your bladder.

General rules when preparing for x-rays with the introduction of contrast:

• give up brown bread and dairy products 24 hours in advance (pasta and lean meats are allowed);
• the last half day before the procedure, eat only liquid food;
• cleanse the intestines in two hours - on the advice of a doctor, you need to do an enema or take a laxative;
• do not eat before visiting the clinic (if possible, then do not drink anything);
• refuse (if the doctor has allowed) from taking medications.

How do they do it?

The procedure takes about ten to fifteen minutes and does not cause much discomfort to the patient. Be sure to take off your watches and jewelry, and also free your upper body from clothing. The position in which irradiation occurs depends on the type of device and medical indications - in some cases you will need to lie on a table, and in others you will need to sit down.

Your doctor will tell you in detail how an X-ray with contrast is performed and will be repeated by the radiologist at the diagnostic center immediately before starting, but in general the only difference from the classic version is the introduction of a contrast agent.

There are two methods of administration: orally or through a special probe. Once in the body, barium fills those areas that were previously not visible on the images, providing maximum visualization of the organs.

Alternatives to barium include air, water-soluble medications, and nitrous oxide. The choice of contrast depends on the expected pathology of individual sensitivity to drugs. In some cases, patients undergo fluoroscopy to monitor stretching, displacement and contraction of the internal walls.

After the necessary images are obtained, the doctor allows you to get up from the table and get dressed. Additional measures are not required to remove the contrast agent from the body - it will be released along with the feces.

Can this be done for children?

For children under 14 years of age, doctors recommend using ultrasound for diagnostic purposes, but this method is not always sufficiently informative and can replace x-rays. For children, X-ray examinations are carried out exclusively as prescribed by a doctor in the absence of other options for detecting pathology and in the presence of clear indications, such as:

• intestinal obstruction;
• peritonitis;
• congenital structural anomalies;
• serious dysfunction of the kidneys or ureters;
• suspicion of an oncological process.

In the practice of treating children, survey radiography of the abdominal organs is used - it is performed on the recommendation of a surgeon, gastroenterologist or oncologist. Based on the images, the doctor can detect free gases, tears and perforations, foreign objects, areas of obstruction, ascites and urolithiasis. Timely diagnosis can save a child’s life, so you should not refuse a test if a doctor has prescribed it.

How and who issues the conclusion?

The duration of decoding depends on the type of equipment used and the level of qualification of the doctor. Digital research involves the delivery of results in 10-15 minutes, and if you need to develop the film, then the conclusion of the radiologist (he is the one who evaluates the images) is provided in a couple of days.

Guided by the specialist’s conclusions, the attending physician decides whether additional research is needed, what diagnosis and what treatment methods to use to restore the patient’s health.

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 the emergency diagnosis of diseases of internal organs. In addition, there are a number of 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 barium is evacuated from different sections. This makes it possible to visualize both structural changes in the intestine and disturbances in 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 of foreign bodies.
• Defects of the abdominal organs.
• Is there an obstacle to the movement of 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. Therefore, this diagnostic method is 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 abdominal pain;
• 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 conditions, 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;
• a day, avoid eating raw vegetables, black bread, lactic acid products, as they increase 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 the initial parts of the 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 prohibited to conduct research) and relative (it is permitted only in extreme cases, when the possible risk is less than the expected 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;
• the patient’s serious condition, in which it is impossible to transport him to the X-ray room;
• open pneumothorax - a pathology in which air from the environment enters the pleural cavity located around the lungs;
• bleeding.

Contraindications to contrast radiography

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

• liver and kidney failure with severe course;
• allergy to contrast components;
• diabetes mellitus in the stage of decompensation;
• active tuberculosis;
• severe thyroid disease.

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 in a 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 Kloyberg cups are low and wide, and also located closer to the center, this indicates small 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 from the cups which part is involved in the pathological process, contrast radiography of the abdominal cavity can be done. In this case, distended intestinal loops are clearly visualized.

Signs of small intestinal obstruction:

• 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 cases when the x-ray picture is 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 x-rays.

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.

We can conclude that radiography of the abdominal organs is a truly effective method in the initial stages of diagnosing a number of pathologies of the abdominal organs. And if intestinal obstruction or perforated ulcer is suspected, his role is simply invaluable.