Abdomen - Lateral Decubitus

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Abdomen - Lateral Decubitus
Area Covered	The abdomen, from the diaphragm downwards
Pathology shown	Air-fluid levels, pneumoperitoneum, bowel obstruction,
Radiographic Anatomy	Abdomen Radiographic Anatomy
IR Size & Orientation	35 x 43 cm Portrait D.R. may cover 43 x 43 cm
Film / Screen Combination	Regular (CR and DR as recommended by manufacturer)
Bucky / Grid	Moving or Stationary Grid
Filter	Yes, a decubitus filter can be used, except in slim patients. This will help to even out the soft tissue of the abdomen which gravity will move closer to the table bucky.
Exposure	80 kVp 40 mAs
FFD / SID	100 cm
Central Ray	Directed to the midsaggital plane, 5cm superior to the level of the iliac crests Perpendicular to the IR
Collimation	Centre: To the midsaggital plane, 5cm superior to the level of the iliac crests Shutter A: Open to IR size inferiorly and superiorly to include the diaphragm and as much of the abdomen as possible Shutter B: Open to include the lateral skin margins if possible
Markers	Inferior and Lateral Marker orientation AP or PA, depending on the patient's position
Shielding	Gonadal for males (check your department's policy guidelines)
Respiration	On suspended expiration- check your department's technique protocol
Positioning	If possible, the patient should be in the decubitus position for at least 10 minutes prior to the image being taken to best show any free gas Patient lateral recumbent position (laying on their left side with their back to the wall bucky) Make sure there is no rotation of the torso Ensure there are no artefacts, such as zips or buttons over the area being imaged Centre the midsaggital plane of the patient to the midline of the IR Bring both hands above the head to remove the arms from the field of view
Critique PACEMAN	Positioning No rotation as evidenced by symmetrical iliac wings the sacrum is centred in the pelvic inlet the pedicles of the vertebrae are the same distance from the spinous processes on each side Area Covered The diaphragm, abdomen Collimation Centre: L3 Lumbar vertebra, which is approximately 5cm superior to the level of the iliac crests Shutter A: Open to include the entire diaphragm superiorly Shutter B: Open to include the lateral skin margins if possible Exposure There should be adequate exposure and no patient motion so that the following anatomy is shown the outline of the psoas muscles the outline of the kidneys gas bubbles are sharply defined skeletal structures such as the posterior ribs, vertebrae and pelvis The contrast and density should be uniform over the abdomen
Special Notes	Annotation Annotate the image to indicate either "L side up " or "R side up" either "AP" or "PA"