Must be taken during the pause after expiration.
Positioning and immobilisation of the patient are critical. Either the
right or left recumbent lateral projections should be used consistently
to eliminate this as a variable. Standard views of the abdomen are
the
lateral
and VD views. Standing lateral views use a horizontal beam direction through
a standing animal and indicate fluid levels in the intestine or abdominal
cavity. Special lateral recumbency views direct the beam horizontally through
an animal in left lateral recumbency in the VD direction. These are used
to detect small amounts of air in the abdomen. Oblique views are directed
through the animal placed in VD or DV position and rotated 15 to 30°.
These allow better visualisation of the oesophagus, stomach, colon, and
urinary bladder by moving them away from the spinal column.
Air in the abdomen:
Will go to the non-dependent site. Air first appears against the diaphragm.
Usually only the lung side of the diaphragm is seen because the abdominal
side is summated with the liver tissue. If both sides can be seen at once
there is air in the
abdomen.
Horizontal views are used to detect a small amount of air in the abdomen.
The animal is placed in left lateral recumbency (left side down).
A small amount of gas present will be detected between the right lobes
of the liver and the diaphragm.
The right lateral recumbent view is preferred
to the left lateral view, as the spleen is more consistently identified.
Positioning of film: Include the entire abdomen from the pelvic inlet to the diaphragm and centre the x-ray beam at the mid-abdomen. Put the thickest end towards the cathode because of the heel effect.
Viewing abdominal films: Just as in the thorax, viewing needs to be systematic and consistent. The abdominal cavity is framed by the caudal thorax, diaphragm, spinal column, musculature of sublumbar soft tissue, the pelvis and the ventral body wall. It is essential to know anatomically where organs are located; if an organ not normally visualised is seen this indicates a problem. Mobile structures of the abdomen, such as the small and large intestines, can be displaced. A displaced organ may itself be normal but be displaced by an abnormal structure not seen.
Boundaries of abdomen
Cranial – diaphragm
Dorsal – spinal column
Caudal – pelvic inlet
Lateral and ventral – abdominal muscles
Ventral – rectus abdominis muscle
Quadrants
Draw two imaginary lines on the VD abdominal
view. The first line runs down the midline and the second is perpendicular
to it, passing through the mid-abdomen. This divides the abdomen into four
quadrants. Knowledge of the contents of each quadrant assists in interpretation
of radiographs. The greatest number of individual structures are located
in the cranial quadrants.
Lateral
view of the abdomen
1. Liver: most
cranial, contacts the diaphragm. The stomach is caudal to the liver.
2. Spleen:
its distal part is seen as a triangle in the ventral abdominal wall just
caudal to the liver.
3. Right kidney:
appears in the craniodorsal abdominal cavity. Its cranial pole is embedded
in the caudate process of the liver, and so is not seen.
4. Left kidney:
½ kidney length caudal to the right kidney and usually can be completely
seen. It is also usually more ventral than the right kidney.
5. Transverse colon:
crosses the abdomen caudal to the stomach and is seen in cross section
when distended with gas.
6. Descending colon:
usually sllightly ventral to the spine andextends caudally to the pelvis
where it joins the rectum.
7. Urinary bladder:
caudoventral abdomen. Situated more cranially in the female than
in the male.
A. Diaphragm
B. Liver: between stomach and diaphragm
C. Fundus of the stomach: located on the
left side of the abdomen
D. Body of the stomach: crosses the midline
E. Pylorus: located on the right side of
the abdomen in the dog, on the midline in the cat
F. Duodenum: passes down the right side
of the abdomen
G. Small intestines: mostly on the right
H. Caecum: located on the right side of
the abdomen caudal to the last rib.
I. Ascending colon: located on the right
side
J. Transverse colon: crosses midline from
right to left
K. Descending colon: travels down the left
side
L. Spleen: located caudal to the stomach
on the left side
Right lateral recumbency
(left side up) – air in the fundic region located in the dorsal abdomen.
Left lateral recumbency
(right side up) – air in the pyloric region located in the ventral aspect
of the abdomen.
VD (ventral side up):
gas will be in pyloric antrum and body, which are in the ventral part of
the abdomen.
Stomach axis:
Can be seen if there is gas in the stomach. Clinically the axis of the
stomach is used to evaluate the size of the liver.
In the lateral projection the normal position of the stomach axis falls
between a line drawn vertical to the spine and a line parallel to the ribs.
The pylorus is superimposed over the body or slightly cranial to it (10th-11th
ribs). In the VD view the axis of the stomach is perpendicular to
the spine in the dog but lies completely to the left side of the spine
in the cat.
Spleen
Lateral projection of the spleen: appears
as a soft tissue triangle in the middle of the ventral abdomen, just behind
the liver in the dog. It is only occasionally visible in the cat.
VD projection: the head of the spleen appears
as a triangular shape lateral to and caudal to the stomach. Occasionally
it may be seen superimposed over the caudal portion of the right kidney.