Abdomen radiograph (pediatric)
The abdomen radiograph is a commonly requested examination in the pediatric patient. Children that present for abdominal x-rays are often very unwell, therefore specialized techniques and appropriate communication are essential for gaining the child's cooperation.
Performing abdominal radiography on pediatric patients can be requested for the following indications 1,2:
- swallowed foreign body
- bowel perforation
- bowel obstruction
- inflammatory bowel disease
- necrotizing enterocolitis
- AP supine view
- AP supine (neonate) view
PA erect view
- ideal for demonstrating air fluid levels and free air under the diaphragm 1
lateral decubitus view
- ideal for demonstrating free abdominal air 1
- cross-table lateral view (neonate)
Patients should remove any clothing or jewelry overlying the abdominal area; including pants, t-shirts and underwire bras. In particular, clothing with metal or shiny decorative material must be removed. Wet diapers are also known to create artifact on the radiograph, therefore should be removed 3.
Tips for pediatric abdominal radiography
- pediatric patients may feel uncomfortable when bony landmarks are felt for, therefore an appropriate explanation to the patient beforehand is ideal for improving patient comfort.
Immobilization techniques will vary from department to department. Since blankets or immobilization devices can often obscure the abdominal area, distraction techniques might be the most ideal form of immobilization. Some distraction techniques that can be used are:
- using toys, games or conversation
- using child-appropriate language (e.g. 'stand still like a soldier' and 'breathe in, you are about to go diving underwater!')
- for younger babies, asking the parents to sing the child's favorite song
Otherwise, a radiographer or parent being in the room with the patient holding them still has been cited as a commonly used technique 4 in the Australian context, however with this method, the parent or staff will receive some scattered radiation dose.
- 1. Maryann Hardy, Stephen Boynes. Paediatric Radiography. (2003) ISBN: 9780632056316
- 2. Sarah J. Menashe, Ramesh S. Iyer, Marguerite T. Parisi, Randolph K. Otto, Edward Weinberger, A. Luana Stanescu. Pediatric Abdominal Radiographs: Common and Less Common Errors. (2017) American Journal of Roentgenology. 209 (2): 417-429. doi:10.2214/AJR.17.17889 - Pubmed
- 3. Markowitz RI, Altes TA, Jaramillo D. What causes the "wet diaper" artifact? computed tomography and magnetic resonance observations. (2009) Clinical imaging. 33 (3): 226-30. doi:10.1016/j.clinimag.2008.09.013 - Pubmed
- 4. Ng Jessica Hui Shi and Edel Doyle. "Keeping Children Still in Medical Imaging Examinations- Immobilisation or Restraint: A Literature Review". Journal of Medical Imaging and Radiation Sciences (2018). . doi:10.1016/j.jmir.2018.09.008.
Related Radiopaedia articles
- radiographic positioning and terminology
- systematic radiographic technical evaluation
- pediatric immobilization
- foreign body ingestion series
- foreign body inhalation series
- chest radiography
- abdominal radiography
- pelvic girdle radiography
- upper limb radiography
- lower limb radiography
- skull radiography
- spine radiography
- skeletal survey