Abdomen radiology: Rad Tech

Abdominal radiology produces images that clearly show soft-tissue outlines of organs such as the liver, spleen, and kidneys, as well as intestinal, or bowel gas patterns.

Many of these images are performed to evaluate acute abdominal pain, possible bowel obstruction, or suspected perforation.

Because plain abdominal radiographs are typically performed without contrast, proper positioning is key to demonstrating free intraperitoneal air-fluid levels and abdominal gas patterns that may signal an acute problem.

As a radiologic technologist, your technique directly affects diagnostic accuracy and supports patient safety.

Now, let’s connect each common abdominal projection to the clinical question it helps answer.

Each projection provides different information, and together they help clarify the cause of abdominal symptoms.

The most common plain abdominal projection is the anteroposterior, or AP projection where the patient is laying supine.

It's called the KUB, because it includes the regions of the kidneys, ureters, and bladder. This is used to evaluate bowel gas patterns, soft tissue outlines, calcifications, and other abdominal findings; or as a scout image before a contrast study.

For acute abdominal symptoms, additional projections may include an erect AP projection or a left lateral decubitus projection when the patient can’t stand. These projections help demonstrate air-fluid levels and can show free intraperitoneal air.

Other abdominal views may be ordered for specific clinical questions.

For example, a posteroanterior, or PA, prone abdomen projection is a special projection used for certain abdominal pathologies, but it is not the preferred view when the kidneys are the main area of interest.

A dorsal decubitus abdomen projection is performed with the patient lying on their back, and the X-ray beam is directed horizontally, producing a lateral projection.

This is different from a standard lateral abdomen projection, where the patient lies on their right or left side, and the beam is directed perpendicular to the table. These less common views may help evaluate specific findings, such as air-fluid levels, soft-tissue masses, calcifications, or foreign body location.

Patient preparation and positioning are important because they directly affect how clearly the abdominal structures and gas patterns appear. For routine plain abdominal radiographs, preparation usually means removing clothing and radiopaque objects from the area being imaged and having the patient wear a gown. NPO, or “nothing by mouth,” is more commonly used for scheduled contrast studies or other exams when department protocol requires it.

Motion control is essential, so you'll instruct the patient to hold still after breathing out. End expiration moves the diaphragm into a higher, more stable position and reduces motion during the exposure.