Philadelphia, PA: Elsevier/Saunders, 2014 Rosen's Emergency Medicine: Concepts and Clinical Practice. Almaramhy, Hamdi Hameed Acute appendicitis in young children less than 5 years: review article, Italian Journal of Pediatrics, 10.1186/s1305-2, 43, 1, (2017).The practitioner should start with a KUB and possibly an upright chest x-ray and obtain additional radiographs as indicated. The most common view of the abdominal radiograph is the anteroposterior projection in the supine position. This is not negligible when increased cancer risk may occur between 10 and 100 mSv. The radiation exposure for an AXR 1.2-1.5 mSv exposure per abdominal film which can equate to 75 chest x-rays. This increases healthcare cost and unnecessary radiation to the patient. Plain abdominal radiography is frequently over-ordered in the emergency setting and are often the only imaging study obtained (Greene Indications for plain AXR). Rothrock, Green, and Hummel found the presence of prior abdominal surgery, foreign body ingestion, abnormal bowel sounds, abdominal distention, or peritoneal signs was 93% sensitive in detecting diagnostic radiographs in children presenting with major diseases. Realistically the abdominal radiograph (AXR) should be ordered when there will likely be a finding for a suspected disease process and the imaging will change management. The American College of Radiology have listed the 16 indications for abdominal radiography (table at right). There has been constant debate surrounding the indications and utility of abdominal plain imaging. Evaluation of colon transit time using the simplified radiodense marker colon transit test.Evaluation for suspected retained video endoscopy capsule and determination of location of patency capsule.Localization of pancreatic duct stone pre-lithotripsy and endoscopic stone removal.Evaluation of a palpable mass in an infant or child.Evaluation of unstable patients after blunt trauma to the abdomen.Evaluation of the placement of medical devices.A scout radiograph prior to a planned imaging examination, ie, fluoroscopy.Evaluation of ingested or other introduced foreign bodies.Evaluation and follow-up of urinary tract calculi, including assessment of lithotripsy patients.Follow-up of the postoperative patient, including detection of inadvertent retained surgical foreign bodies.Evaluation of congenital gastrointestinal abnormalities.Evaluation for necrotizing enterocolitis, particularly in the premature newborn.Constipation, especially assessment of fecal load in children.Evaluation and follow-up of abdominal distention, bowel obstruction, or nonobstructive ileus.Ultrasound Welcome Policies Scanning School Machines Machine Care Ultrasound of the Month Faculty Credentialing Resources QpathE Workflow Jewish Hospital Ultrasound Contact.Procedures Procedural Education Arterial Line Central Line Chest Tube Cricothyrotomy Lumbar Puncture Procedural Sedation Regional Anesthesia Transvenous Pacemaker IC Cordes / Airway.Operations Logistics SPAMs UC Policies WCMC Operations WCMC Consults.Resident Education Hit the Box Grand Rounds Bread & Butter EM Electives Global Health Journal Club Social Media Primer Wellness.Prehospital EMS Air Care Orientation Air Care Education Air Care Equipment Air Care Medications Air Care Procedures Air Care Quick Reference Air Care Nuts & Bolts Air Care Safety Air Care Secure.Emergency KT EmergencyKT CC Evaluation Guidelines Clinical Practice Guidelines Common Forms Observation Protocols Outpatient Follow Up/Resources Antibiograms. The Abdominal XRay: A relic or a reliable tool? - Taming the SRU Top Taming the SRU
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