Topic: Laryngeal, oral and esophageal tumors
Question:Discuss the role of x-ray imaging in diagnosing a case of acute abdomen.
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X-ray imaging can be very helpful in diagnosing causes of acute abdomen:
– Plain abdominal X-ray: Can diagnose intestinal obstruction (dilated small bowel loops, air-fluid levels), perforation (free air under diaphragm), ileus, toxic megacolon, colonic volvulus.
– Chest X-ray: Helps rule out diaphragmatic irritation from subdiaphragmatic pathologies. Can show free air under diaphragm suggesting perforation.
– Upright abdominal X-ray: Useful for identifying free air under diaphragm in cases of perforation. Air rises to undersurface of diaphragm.
– Contrast X-rays: Barium swallow/meal follow through can diagnose malrotations, charcot’s triad (constricting lesions of intestine), obstruction.
– CT abdomen: Gold standard imaging for acute abdomen. Helps identify inflammation, infection, perforation, ischemia, obstruction and more.
– Ultrasound abdomen: First line for suspected biliary pathologies like cholecystitis, cholangitis. Also useful for appendicitis, pancreatitis, pelvic pathologies.
Key advantages of X-ray:
– Widely available, cost effective
– No radiation exposure with plain films
– Upright films best for detecting free air under diaphragm
– Can diagnose obstructive patterns
Limitations:
– Ionizing radiation exposure in CT
– Less sensitive than CT for subtle pathologies
– Poor soft tissue resolution compared to CT/USG
