The current role of abdominal X-ray

Background / Objective 1. To review and illustrate the most common findings in abdominal X-rays. 2. To clarify the value of abdominal radiographs for diagnosing abdominal pathology. Methods An initial single-center retrospective review was conducted between the 1st and 31st of July, 2023, of all abdominal radiographs (ABX). A total of 272 ABX were performed, comprising 238 cases from the adult population and 34 patients from the pediatric. The most representative cases were selected to illustrate primary imaging findings. Results The study involved 272 patients: 120 (44.1 %) men and 152 (55.9 %) women. The mean age of patients was 52.4; the median was 57.5 (aged 5 months to 95 years). Of the total abdominal X-rays performed, 203 (74.6%) were reported normal, and 69 (25.6%) as abnormal. The most common finding was intestinal obstruction in 46 (16.9 %) cases. A foreign body was observed in 8 (2.9 %) patients, migrated stents in 4 (1.5 %) patients, pneumoperitoneum in 3 (1.1 %), and other findings (calcifications, fecoliths, drains) were seen in 8 (2.9%) patients. Fig 1: The child was observed to swallow a coin. A coin was seen in the projection of the stomach (arrow). Fig 2: Free air was visible on both sides under the diaphragm (arrows) due to gastrointestinal perforation. Fig 3: A patient with severe ulcerative colitis. Abdominal roentgenogram showing thumbprinting (arrow) Fig 4: Sigmoid volvulus - 'coffee bean' sign (arrow). Fig 5: Stent in the projection of the duodenum (arrow). Fig 6: An enteric stent (arrow) was placed after tumor surgery. Fig 7: A right ureteric JJ stent (arrow) has been placed to relieve ureteric obstruction. Fig 8: Two-year-old girl swallowed multiple magnets, which caused an intestinal obstruction. Fig 9: Abdominal radiograph shows small bowel dilatation with multiple air-fluid levels. Air-fluid level wider than 3.5 cm (horizontal line). Fig 10: The patient has swallowed wires (arrow) visible in the abdomen's central part. Conclusions Despite its limitations, ABX provides valuable information on the patient's clinical condition and has a role as a first-line imaging modality for initial patient assessment. It assists in determining the need for further imaging.