Tuesday, December 6, 2011

Upright AP Projection - Abdomen

   Upright xray examination of the abdomen is usually suggested when the Kidneys, Uriters and Bladder (KUB) are not the primary interest to be examine. Abdominal masses, air fluid levels and accumulation of intraperitoneal air under the diaphragm is best demonstrated in this position. 

Technical Factors:

  • 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:

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

AP Projection Abdomen (Erect)

abdomina radiography
AP Upright Position

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 bucky.
  • No rotation of pelvis and shoulders.
  • Adjust height of the bucky so that the center of IR is approximately 2 inches or (5cm) above iliac crest (this is to include the diaphragm). On the average patient this will place the top of the IR at approximately in the level of the axilla.
abdominal radiography
Abdominal Radiograph

Central Ray, Collimation and Respiration

CR is horizontal and center of IR
Minimum SID of 40 inches or (100 cm)
Collimate closely on all four sides of the part being examine; be sure not to cut off the upper abdomen to included diagphragm.
Exposure should be made at end of expiration.

Note: Before making an exposure, the patient should be in an upright position for about 5 minutes. But it is advisable that 10 to 20 minutes is usually done if the patient can tolerate. In this length of time, the small amount of air in the intraperitoneal cavity of the lung, eventually will go up and become visible if present on the radiograph. Otherwise, if the patient is too weak, and cannot maintain its erect position for a long period of time, a lateral decubitus can be use. Also for hypersthenic patients, two crosswise radiographic film may be required to include the entire abdomen on the radiograph.

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