Name some "can't miss" findings on abdominal radiographs in kids.
Free intraperitoneal gas (a.k.a. "free gas"), pneumatosis intestinalis (gas in the wall of the bowel), portal venous gas (gas in the portal venous system). See the trend here? Always look for gas where it shouldn’t be!
What is the purpose of obtaining the lateral decubitus radiograph?
Lateral decubitus radiographs are the test of choice for evaluation for free intraperitoneal gas when a patient is unable to sit upright for a chest radiograph.
Name the major findings on these radiographs. Are there any "can't miss" findings?
Mildly dilated loops of bowel are seen. Additionally two red flags are identified portal venous gas and pneumatosis intestinalis.
Mildly dilated loops of bowel with pneumatosis intestinalis and portal venous gas. No free intraperitoneal gas is identified. Tight windowing allows for easy visualisation of pneumatosis and portal venous gas.