The acute abdomen: Plain radiographic evaluation

With the development of computed tomography, ultrasonography and specialized scintigraphic techniques, conventional radiographic imaging of the abdomen has generally been relegated to a minor position in each of the three clinical entities under discussion in this series. On the other hand, one can make a good case for routinely obtaining radiographs of the abdomen in most patients with an acute abdomen. The information available on the plain radiographs regarding the amount and distribution of intestinal gas, recognition of extratuminal gas collections, significant calcifications, organomegaly and the demonstration of soft tissue masses or fluid collections can be critical in making a specific diagnosis or in suggesting a possible diagnosis. This information may be useful in planning the subsequent workup. In this section, the role of conventional radiography, including plain radiographs and traditional contrast studies of the abdomen, will be discussed in the workup of patients with suspected acute cholecystitis, subhepatic abscess and splenic trauma.