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ABDOMENABDOMEN
Vanda Yp
PPDS I Radiologi FK UNDIP / RSUP Dr. Kariadi
Semarang
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!. Um"mn#a $ AP2. %oli& a'domen $ AP(. Ile") $
APSemiere*+ / , d"d"&
--D
. %"riga adan#a perora)iAP
Semiere*+--D
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Foto polos:
0ora& PA
F+ Polo) A'domen 1FPA
FPA ( a+a" 2 po)i)i. Pem dengan kontras:
3Sialogra4
3Ba meal 1 OMD
3Ba Follo5 +6ro"g6
3Ba enema
3ER%P
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Paling sering : AP, supine
Batas atas : diafragma. Kedua basis paru
harus tampak
Batas bawah : simfisis pubis
Diambil saat ekspirasi, 1-2 detik setelah
ekspirasi Ideal : empt bladder
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Sinar X arah horizontal
Foto abdomen supine,
pasien telentang,sinar tegak
lurus/vertikal.
LLD
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Foto abdomen tegak, pasien berdiri, sinar horizontal.
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!. Ama+i 7 regio a'domen
2. Kon+"r gin8al
(. P)oa) line. Ada &al)i4&a)i $ le+a&9 8"mla69 'en+"& 9
dan &on)i)+en)in#a
:. Di)+ri'")i dan &ali'er ")")
;. Air
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Gas in
stomach
Gas in a few
loops of
small bowel
Gas in
rectum or
sigmoid
Normal Gas Pattern
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Plain flm radiographyPlain flm radiography 0ampa& 8"mla6
"dara pada ")")&e*il @ lam'"ng.
0ida& +ampa&
dila+a)i pada ")")'e)ar
"mla6 "daranormal pada*olon.
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!as n"rmal di gaster # $"l"n %edikit di usus halus &luid le'el ()*+A : di $"l"n, -, pan/ang
0 2. $m
&luid le'el di small b"wel, , kaliber $m AB()*+A
Udara pada ")") 'erg"na "+& $
Menilai diame+er ")"). Menilai po)i)i ")"). Ban#a&n#a *airan didalamn#a
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Organ yang dapat diidentifkasi darilemak yang melingkupinya :
Ba+a) gin8al.
o+o+ p)oa).
VU.
Peri+one"m.Ba+a) po)+erior 6epar dan lien.
Fat line dapat tergeser o/k :Pem'e)aran organ.
Adan#a in
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Diameter usus ber'ariasi
%mall b"wel : 0 $m
"l"n trans'ersum : 0 3 $m
ae$um : 0 4 $m
ae$um paling distensible 5distended6
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!as sampai di $"l"n 7 menit
se'ere pain is present anwhere in theb"d, "r when respirati"n is lab"ured as in
pneum"nia "r asthma am"unt "f air
swall"wed pr"du$ing a dramati$ PA&
5su$h gas-filled, slightl dilated l""ps "f
b"wel $"ntain relati'el little fluid6 mete"rism
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Tehnik radiograf
1.Posisi supine :
Pre peri+oneal Fa+ line Kanan C &iri.
ari) P)oa) &anan C &iri
Ba+" radioopa&9 &al)i4&a)i9 'enda a)ingradioopa&.
Kon+"r gin8al &anan C &iri.
am'aran "dara ")") Ke)"raman #ang dapa+ di)e'a'&an ole6
*airan dil"ar ")") a+a" ma))a +"mor.
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2.Posisi erect/ semi erect. am'aran "dara *airan dalam ")") /
dil"ar ")"). am'aran "dara 'e'a) di'a5a6
diaragma. am'aran *airan di rongga pel=i) /a'domen 'a5a6.
3.Posisi LLD. am'aran "dara 'e'a) an+ara 6a+i
dengan dinding a'domen a+a" pel=i)dengan dinding a'domen.
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"ga di'"+"6&an o+o +6ora
Krn 'e'erapa pen#a&i+ )p+ $Pne"monia.Inar& par".Di))e*+ing ane"r#)ma.Inar& mio&ard.
mirip dengan a&"+ a'domen
Fo+o dada PA "+& $Meli6a+ gam'aran ree air di 'a5a6 diaragma.Pada &ompli&a)i di dada.A')e) )"'reni& #g merp &ompli&a)i.
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Pneumoperitoneum
resulting from perforation
of a duodenal ulcer. Erect
chest radiograph. Typical free
gas between the liver and theright hemidiaphragm. Note
also the small triangular
collection between the loops
of the splenic flexure of the
colon, beneath the left
hemidiaphragm.
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Anormal !as PatternsAnormal !as Patterns
l Functional "leusn Locali#ed $%entinel
Loops&
n !enerali#ed adynamic
ileus
l 'echanical
Ostructionn %(O
n L(O
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UDARA / GAS MEMBERIUDARA / GAS MEMBERI
GAMBARAN BENTUK USUSGAMBARAN BENTUK USUS
Jejunum
Upper leum
Lo!er leum
"olon
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)sus *alus +olon
*austra , -
alulaconnientes
- ,
0umlah loop 1111
Letak loop %entral Perier
4adius
curatura loop
+ecil (esar
Diameterlumen
35675mm 1 75 mm
'assa eses 6 -
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Adynamic Ileus
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Ileus Paraliti
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Adynamic Ileus
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!mall "owel #bstruction
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Ileus #bstrutif
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Ileus #bstrutif
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$ocali%ed Ileus
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OBS0RUK0IF!. Dila+a)i pada pro&)imal
le)i dengan "dara #gmening&a+.
2. Didi)+al )"m'a+an "daramen"r"n )/d 13.
(. S+ep ladder app 19 *iri $pende& C 'an#a&.
. Gearing 'one 1
:. Penim'"nan *airane&)+ral"minal.
PARA-I0IK!. Dila+a)i ")") 6e'a+ )/d
re*+"m
2. a) 1 )/d re*+"m C
)igmoid.(. S+ep ladder app 19 *iri $
pan8ang C )edi&i+.
. Flan& )+rip.
:. Sering di)er+ai R.Ple"ra.
;. era&an diaragmamen"r"n.
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&ree Air 'Pneumoperitoneum(
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&ree Air 'pneumoperitoneum(
)
)
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&ree air
'pneumoperitoneum(
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Pneumoperitoneum
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)iggler sign
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A!*ITE!
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Appendicolith
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Atresia Ani
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+reterolitiasis
sinistra
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uodenal atresia
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"ayi sungsang
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An MK / ? +6n. Ile") o')+r"&+i
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Fo+o polo) $ +ampa& gam'aran opa&)eper+i )i)a )i)a ma&anan pada6emi+6ora &anan.
Pemeri&)aan OMD $
0ampa& &on+ra) mengi)i oe)op6ag")9
ga)+er dan d"oden"m. Pa)a)e &on+ra)aga& +er6am'a+ &e+i&a melal"ioe)op6ag") !/( medial dan di)+aldi&arena&an 'an#a&n#a )i)a ma&anan#ang +er+a6an .
0ampa& gam'aran dila+a)i oe)op6ag")pada 'agian !/( +enga6 dan !/( di)+al .
0a& +ampa& &elainan pada ga)+er dando"den"m .
+8%A9 : !A'(A4A9 A*ALA%"A