The Abdominal Plain Film- Terminology

Introduction

There are a number of terms that are used frequently in reference to the abdominal plain film. These terms are defined below.

Terminology

The Abdominal Plain Film

This is an outdated term that referred to a supine abdominal radiograph. It predates digital radiography but is still used by some radiographers today.

Acute Abdomen

A patient who has acute abdominal symptoms

Fulminant

Developing or progressing suddenly, severely or rapidly

Quiescent

Inactive

Dependent

The concept of dependent and non-dependent positions is an important concept in imaging and particularly useful when discussing the abdominal plain film. Consider a loop of bowel that is half filled with fluid and half filled with air- the contents of the loop of bowel will be subject to gravitational forces causing the fluid to always settle to the lowest point and the air to always rise to the highest point. The fluid that settles to the lowest point is said to occupy the most dependent part of the bowel. The air that rises is said to occupy the least dependent part of the bowel

Efface

Wipe out, destroy, obliterate

Ileus

The term ileus appears to have undergone a subtle change in meaning/usage. The term Ileus originally was used to denote stasis of bowel contents. The term had two common uses

• Adynamic Ileus ( syn paralytic ileus, non-obstructive ileus)
• This referred to non-functioning bowel for reasons other than obstruction
  

• Obstructive Ileus
• This referred to stasis of bowel contents for reasons related to obstruction

It appears, for reasons of economy, the terms where abridged as follows

Adynamic Ileus ----------> was shortened to ----------> Ileus
Obstructive Ileus----------> was shortened to ----------> obstruction

Thus, with its current meanings, you will hear a clinician ask a radiologist whether he/she thinks a patient has ileus or obstruction. To make matters even more complicated, some countries still use the original meanings of these two terms. Some radiologists avoid the issue by describing an appearance as demonstrating a "motility disorder". The term 'motility disorder' does not distinguish between ileus and obstruction.

Motility Disorder

This term refers to abnormal motility of bowel contents without specifying whether it is obstructive or non-obstructive in nature.

Valvulae Conniventes

The small bowel has a wall pattern that is known as valvulae conniventes (white arrow). The muscular bands encircling the small bowel are usually seen to traverse the bowel wall at right angles to the long axis of the bowel

Plicae Semilunaris and Haustra

The large bowel wall features pouches or sacculation that protrude into the lumen that are known as haustra(black arrow). You will hear radiologists refer to the bowel's "haustral pattern". In between the haustra are spaces known as plicae semilunaris- white arrow (semilunaris refers to their semi-lunar shape)

Stomach Rugae

The mucosal folds of the stomach are known as rugae(arrowed). These are often seen on abdominal plain film and are sufficiently characteristic to confidently distinguish the stomach from the other hollow viscus

Abdominal Viscus

Abdominal Viscus Solid Hollow liver spleen pancreas kidneys ovaries stomach small intestine large intestine gall bladder urinary bladder uterus

The abdominal viscus refers to the abdominal organs. These can be divided into solid viscus and hollow viscus

Properitoneal Fat

The abdominal cavity has a lining of fat of variable thickness known as the properitoneal fat. This is often seen as a fat density stripe along the lateral wall of the abdomen on an AP abdominal plain film(white arrow).

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