Abdominal X-Ray

Plain abdominal X-ray belongs among basic radiographic examinations. It is cheap, widely available and cheap examination. Despite its simplicity, it can bring a lot of information and helps to quickly diagnose many serious situations.


Liquid levels in the gut

Liquid levels with air above them (hydroaeric phenomenon) in the intestinal cavities are typical signs of intestinal obstruction (ileus). In mechanical ileus, we can estimate the location of obstruction from the occurrence of the liquid levels.

Air in the abdomen

The air in the abdominal cavity is known as the pneumoperitoneum. The air is always displayed in the upper part of the X-ray image according to the position of the patient. When standing, the air is located just under the diaphragm, while in patient in horizontal position lying on his back, the air is just below the front wall of the abdomen. Pneumoperitoneum is a very serious symptom that usually means intestinal perforation or rupture of the stomach and duodenum (typically by perforated peptic ulcer). A certain disadvantage is that the abdominal X-ray can not say anything about the location of the rupture.

Foreign bodies

Many foreign bodies (usually swallowed or aspirated) may be displayed on the X-ray, which helps to determine their location. This is especially valuable in swallowed object inside the gastrointestinal tube. Of course, the objects must be visible for the X-ray.

Contrast stones

Stones may occur in many tissues and hollow organs of our body. The most clinically significant are urinary stones and gallstones. However, the visibility of the stones depends on their composition. Many types of gallstones are much better visible by abdominal ultrasound.

Porcelain gallbladder

Porcelain gallbladder is a condition associated with calcium deposition in the gallbladder wall. The reason is not entirely clear, but it may be related to long-term presence of gallstones and chronic inflammation of the gallbladder. Calcified gallbladder wall is visible in the X-ray image. Calcified wall of the gallbladder can be also visualized by ultrasound.


There is no preparation needed. The procedure does not have to be performed on empty stomach and no contrast agent is used. This makes it an ideal first-line examination method.


X-ray examination of the abdomen is very cheap and available. The radiation exposure is minimal and the method helps to quickly rule out (or confirm) many serious conditions (see above).


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources