The abdominal x-ray is a test that can be carried out quickly and easily in an emergency department. The test can help diagnose some abdominal conditions. It is not a useful investigation for most abdominal conditions. Small and large bowel obstructions, volvulus and malrotations can be diagnosed by AXR. Renal, urethral and bladder stones can sometimes be identified on plain x-ray, although it is usual now to use CT as a first line investigation to confirm clinical suspicion. Gallstones are sometimes noted on x-ray, although ultrasound is the more usual imaging modality used when clinically suspected. Plain abdominal radiography is not usually helpful in diagnosis of appendicitis.
In an acute setting the abdominal x-ray is used to diagnose:
- Bowel obstruction with air fluid levels generally seen on X-ray.
- Bowel perforation although this is more commonly diagnosed by a Chest x-ray
- Kidney stones or Gall stones Further tests are used to confirm these diagnoses and abdominal x-ray is not the investigation of choice
- Faecal impaction although this should be diagnosed by history taking and clinical examination