Approach to Abdominal Film Interpretation

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

• Not applicable

Approach/Discussion:
Think CBA (C - Chest, B - Bones, A - Abdomen)

C - Chest: lower lung fields - look for pneumonia, diaphragm - look for free air on an upright film

B - Bones: check for neoplastic change or fractures or infections or metabolic changes

A - Abdomen: psoas shadows - if obscured think of a retroperitoneal process occurring, properitoneal fat lines - look for peritoneal fluid, soft tissues (liver, gall bladder, spleen, kidneys, pancreas, ureters, bladder) - check their size and shape and location and look for any abnormal calcifications in them, gas pattern in bowel from esophagus to anus

Cases to Practice On

1. Newborn who "looks funny" - Supine
2. 5 month old with vomiting and a distended abdomen - Supine | Upright
3. Newborn with bilious vomiting - Supine | Upright
4. 4 day old with vomiting and a palpable abdominal mass - Supine | Upright
5. 7 month old with vomiting - Supine | Upright
6. 3 week old with vomiting - Supine | Upright
7. Newborn with vomiting - Supine
8. Newborn who can't have an NG tube placed - Supine | Upright
9. 1 day old with a distended abdomen - Supine
10. Newborn with failure to poop - Supine
11. 15 year old with abdominal pain - Supine
12. 13 year old who is short of change - Supine

References:
See References Chapter.

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