Plain radiology of the abdomen

The plain abdominal radiograph should be reviewed systematically:

• name and date on the radiograph should be checked
  
  
• stomach gas on the left side of the abdomen
  
  
• boundaries:
  • diaphragm
  • psoas muscles
  • extraperitoneal
  • fat
  • hernial orifices
    
    
• bones:
  • costal cartilages and lower ribs
  • lumbar spine
  • pelvis
    
    
• hollow visceral gas: stomach, small and large bowel
  
  
• solid organs: check size of liver, spleen and kidneys
  
  
• vascular: check for aortic calcification
  
  
• abnormalities: renal (90% radio-opaque) or biliary calculi (10% radio-opaque), dilated bowel, air in the biliary tree
  
  
• an erect chest X-ray may reveal peritoneal free gas as air under the diaphragm