A15. X-ray signs in the abdomen

Abdominal x-ray is the x-ray of the abdomen a seldom used examination in the evaluation of abdominal disorders. It may be performed with oral contrast (a sort of contrast porridge one eats) or without.

Signs without contrast

Sign	Description	Condition
Pneumoperitoneum	Air under the diaphragm	Air inside the abdominal cavity, usually due to bowel or ulcer perforation
Air-fluid levels	Horizontal air-fluid levels in the small or large intestine	Ileus
Pneumobilia	Air inside the biliary tree	Biliary-enteric fistula
Coffee bean sign	Dilated loop of twisted bowel which resembles coffee bean	Sigmoid volvulus
Pneumoatosis intestinalis	Air inside the intestinal wall	Necrotising enterocolitis (premature infants)

Signs with contrast

Sign	Contrast	Description	Condition
–	Barium and air enema	Outpouchings of the colonic wall	Diverticulosis
Apple-core sign	Barium and air enema	Apple core-like lesion	Colon cancer