Supine Abdominal Films

In the past decade, the utility of the supine film for the detection of free air has been reassessed, and several new observations have been reported.4-6,13-18 The right upper quadrant is the most fruitful place to look for a small pneumoperitoneum,5,6,18,19 because CT studies have shown that free air most commonly accumulates in this abdominal region.8,20 Moreover, the homogeneous shadow of the liver provides an excellent background, enabling small deposits of air to stand out clearly.

The conventional abdominal film, colloquially known as a KUB, often excludes from view the uppermost abdomen, the locus of most collections of free air. This is because the abdomen in many adults is often too long to be encompassed in its entirety on one supine film. This geometric limitation partly explains the 59% detection rate of pneumoperitoneum on supine films in a recent study by Levine et al.18 To recognize subtle signs of free air, the entire right upper quadrant must be carefully scrutinized, sometimes on a separate film. Any lu-cency inconsistent with the expected pattern of gas in the stomach, duodenum, distal small bowel, and colon must be regarded with suspicion.

Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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