Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
When interpreting an abdominal film in the newborn, one should be sure to examine the entire film, and not just the abdomen. Use of the "CBA" approach by the radiologist ensures that all areas of the film are systematically examined.
C - Chest, check for: midline trachea and mediastinum, abnormal mediastinal and cardiac contours, position of the aortic arch, pleural effusions, pulmonary vascularity, pneumomediastinum, pneumothorax, pneumopericardium, infiltrates, and atelectasis.
B - Bone, check for: fractures, lytic or blastic lesions, and metabolic bone diseases.
A - Abdomen, check for: bowel gas pattern suggesting ileus or obstruction, free intraperitoneal air, abnormal calcification, abdominal situs, and diaphragm position.
Gas should reach the sigmoid colon by 8-9 hours after birth. The amount of rectal gas is variable because there is repeated accumulation and passage of flatus. When rectal gas can't be seen on supine views, try taking a prone cross table lateral.
See References Chapter.
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