Indications

Despite the development of other investigations the plain abdominal x-ray still has a role to play in detecting intestinal obstruction, or dilatation and in foreign body ingestion/insertion

The erect chest x-ray is an important initial investigation in the acute abdomen as it is most sensitive for pneumoperitoneum. Remember to exclude possible pregnancy in women of child-bearing age.

A plain abdominal film exposes the patient to 0.7mSv of radiation, equivalent to 35 chest x-rays or four months of natural background radiation in a single episode.

A plain abdominal x-ray should be carried out if there is:

  • Acute abdominal pain, if suspected small or large bowel obstruction. However increasingly abdominal CT is replacing plain abdominal x-ray for this indication as it gives more information, about the cause of obstruction and about alternative diagnoses [1]
  • Exacerbation of inflammatory bowel disease to exclude toxic megacolon