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Generalised abdominal pain for 24 hours and more recent onset of vomiting. Previous surgical history includes
laparoscopic sterilisation 12 months previously.

Patient Data
A G E : 33
G E N D E R : Female

Sterilisation clips demonstrated in the pelvis. Normal outlines of solid organs - the liver has a prominent lower
margin (normal variant - Riedel's lobe). Normal bowel gas pattern. Faeces in ascending colon.

No evidence of obstruction or perforation.

The liver and spleen are seen in the upper abdomen (coloured blue). The liver extends quite low in the
abdomen, but this can be a normal variant (Riedel's lobe). The liver doesn't usually extend below the lower pole
of the right kidney.

Both kidneys can also be demonstrated (yellow) and are held away from the spine by thepsoas muscle.

The right colon (ascending colon) is filled with faeces, but can be traced over the midline to the splenic flexure
and then down the left flank towards the pelvis.
Case Discussion
The cause of the patient's symptoms are not demonstrated on this plain film. The bowel gas pattern is normal
and there is no evidence of obstruction or perforation.

Patient Data
A G E : 59
G E N D E R : Male

Normal appearances. No cause for pain. No evidence of obstruction.

The bowel gas pattern for the large bowel (red) can be traced from the caecum to the rectum. This is possible
because the colon is filled with gas and faeces. Some gas-filled small bowel loops are seen more centrally.
Spinal curvature does not equal scoliosis! If the patient doesn't lie straight when the x-ray is taken, this is the
result. There is background degenerative change, but it's not excessive for the patient's age.
Case Discussion
Normal appearances of this abdominal film. The large bowel is filled with faeces, but not dilated. No evidence
of small bowel dilatation either. Spinal curvature just reflects that the patient wasn't lying straight on this

A normal radiograph doesn't exclude intra-abdominal pathology.