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Plain Films - Abdomen

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General:

  • Supine abdomen to include symphysis pubis and diaphragms.
  • Any acute abdomen to have supine and L lateral decubitus images
  • If febrile, consider PA erect CXR. Chest infection can produce symptoms of abdomen pain and vomiting.
  • If constipated, supine only. Review your images, if bowel gas looks unusual, consider a decubitus.
  • Decubitus image must have patient lying on left side for at least 5 minutes first. Elevate patient on large pad and use horizontal ray +/- grid depending on size.
    For larger patients you can move onto Phillips trolley (found in R2) and use erect bucky with grid.
  • No gonad protection for girls as this may obscure abdomen structures.
    Careful placement of gonad protection is possible for boys.
  • Remove ALL clothing from child including nappies and underpants. Elastic in underpants will be visible on image. Place incontinence sheet beneath baby. Older children can be dressed in a night gown or strategic placement of cloth nappy / draw sheet may be sufficient. Try to eliminate any folds or wrinkles.
 Clinical Indications Patient Position  Comments 
 Abdo pain ? cause
? intussusseption
? bowel obstruction
Supine abdomen
L lat decubitus abdomen
PA erect CXR if febrile
Supine abdomen must include diaphragms and symphysis 
Constipation
Renal colic 
Supine abdomen only If not obviously constipated, may need to do decubitus
Ingested foreign body  Supine with head turned to side
Lateral neck & CXR may be needed if FB is of low density and not seen on initial film eg plastic
Include mouth to anus on one film
If not possible, ensure 2 films overlap
Imperforate anus CXR (supine)
Supine abdomen
L Lateral decubitus
Prone shoot through
Lateral rectum
(discuss with radiologist) 
Neonate - ensure room is warm
Prone shoot through should not be done before 24hrs post natal
Leave at least 5 mins in prone position before film taken - BB on anal dimple if required by radiologist
VP shunt series  AP/ Lateral SXR (soft tissue profile)
Supine chest/abdo

New insertion only, if requested :
Lateral shoot through abdomen    
If head CT has been done at SS do not need SXR Include whole length of shunt :looking for breaks Shunt often extends to pelvis

To check if shunt in peritoneum 
Perforation  Supine AXR
L lateral decubitus
Include diaphragms on AXR   

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Document Control

  • Date last published: 13 October 2017
  • Document type: Imaging Protocol
  • Services responsible: Paediatric Radiology

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