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Useful in certain presentations of the acute abdomen i.e. bowel obstruction, volvulus,
malrotation, renal stones.
Technical details:
Bones on AXR can be used as landmarks for soft tissue not easily visible on x-ray.
Kidneys: lie lateral to the psoas at level the T12 -L3. Right lower due to liver.
Ureter: the transverse processes of the lumbar vertebrae delineate the course of the
ureters.
Abdominal pain
Distension
Absolute constipation
Predisposing factors:
Elderly
Constipation
Chronic immobility
Radiological appearance:
Co!ee bean
Loss of haustra
Vomiting
Fever
Tachycardia
Distension
Adhesions
Malignancy
Crohns strictures
Hernias
Foreign bodies
Atresia
Radiological appearance:
Vomiting
Absolute constipation
Distension
Malignancy
Strictures
Hernias
Radiological appearance:
Perforation of a viscus
Trauma
Radiological appearance:
Rare.
Emphysematous cholangitis.
Gallstone ileus
Riglers triad:
1. Aerobilia
2. Small bowel obstruction
3. Impacted gallstone - usually in
the terminal ileum