Tuesday, December 6, 2011

Upright AP Projection - Abdomen

Abdominal xray examination of the abdomen, the upright position is usually taken if  KUB or kindneys are not the primary interest and patient upright position is suggested for a survey examinations. Pathology like, abnormal masses, air fluid levels, and accumulations of intraperitoneal air under diaphragm are demonstrated. Upright on is suggested for a survey examination Perform erect radiograph first if patient comes to department ambulatory or in wheelchair in an erect position.

Technical Factors:

abdomina radiography
AP Upright Position
  • IR size - 35 x 43cm (14 x 17 inches), lengthwise
  • Moving or stationary grid (use erect markers)
  • 70 to 80 kV range

Marker and Shielding:

Include erect marker on IR.
Used gonadal shield on males. An adjustable freestanding mobile shield can be used as for chests.

AP Projection Abdomen (Erect)

Patient and Part Position:

  • Upright, legs slightly spread, back against table or grid device (see note below for weak or unsteady patients)
  • Arms at sides away from body
  • Midsagittal plane of the body centered to midline of the table or erect Bucky
  • Do not rotate pelvis or shoulders.
  • Adjust height of IR so the center is approximately 2 inches (5cm ) above iliac crest (to include diaphragm), which for the average patient will place the top of the IR approximately at the level of the axilla.

Central Ray, Collimation and Respiration

abdominal radiography
Abdominal Radiograph
CR horizontal, to center of IR
Minimum SID of 40inches (100cm)
Collimate closely on all four sides; do NOT cut off upper abdomen.
Exposure should be made at end of expiration.

Note: Before initiating exposure patient should be in upright position for a minimum of 5 minutes, but 10 to 20 minutes is advisable, in this length of time, the small amount of air in the intraperitoneal will go up and be visualize if present. If a patient is too weak, and cannot maintain its erect position, a lateral decubitus should be taken. For hypersthenic patients, two crosswise image receptor may be required to include the entire abdomen on the radiograph.

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