Abdominal X-ray for Stomach Pain

Abdominal X-rays are often ordered for abdominal pain.  Your doctor may decide to start with an abdominal X-ray since it is fast, inexpensive, readily available and can diagnosis some of the causes of abdominal pain.

When are X-rays ordered for abdominal pain?

Abdominal X-rays are sometimes a starting point for the workup of abdominal pain.  CT scans are more commonly ordered because they are more definitive at ruling in and ruling out disease.

Abdominal pain causes that can be seen on X-ray

The cause of abdominal pain is broad and abdominal X-rays can only sometimes provide a cause. Abdominal X-rays are best for detecting kidney stones, bowel obstruction, and perforated bowel.

What organs does an abdominal X-ray show?

Abdominal X-rays do not show us the abdominal organs.  Abdominal organs all look white on X-ray and are not distinguishable from the surrounding tissues.  We can see air filled bowel.  We can see a part of the spine.

Negative abdominal X-ray but still have stomach pain?

There are numerous conditions which will not be seen on an abdominal X-ray such as appendicitis, pancreatitis, cancer and many other serious conditions. These will often be diagnosed with a CT scan or other tests.

Therefore, abdominal X-rays are just a starting point. If your doctor is concerned about a bowel blockage or twist called a volvulus, then an abdominal X-ray is a start, but can also miss these diagnosis. A CT scan will often be needed to not only diagnose but further evaluate an abnormality on an X-ray.

Can you see stomach inflammation on an X-ray?

No.  there is not enough detail of the stomach on X-ray of the abdomen to make a diagnosis of inflammation.

Kidney stone on abdominal X-ray

A patient who presents with flank pain and blood in the urine may have a kidney stone.  A stone will look like a small white spot along the expected location of the kidneys.

We can sometimes see a kidney stone along the course of the ureters when a patient passes a stone.  A kidney stone can be found anywhere along the urinary tract from the kidneys to the bladder.

Unfortunately, not every kidney stone is identified on an X-ray. Additionally, other benign calcifications can look like kidney stones. If there is continued concern, then a CT scan will be needed.

Can an X-ray show intestinal blockage?

Some intestinal blockages are seen.  A negative abdominal X-ray does not exclude an intestinal blockage.  A CT is more definitive.

Will an abdominal X-ray show pancreatitis?

No, not acute pancreatitis.  We can not see the pancreas and the inflammation which accompanies pancreatitis on X-ray.

We can sometimes see chronic pancreatitis on X-ray.  We will see small calcifications or white spots throughout the expected location of the pancreas on X-ray.

Abdominal X-ray for perforated bowel

A perforated bowel can often be diagnosed on abdominal X-rays. Air normally is only located within the bowel. If there is air outside the bowel in the abdomen, then this can mean that there is perforated bowel.  Air has escaped from the bowel due to a tear of the wall. This will be seen as air under the diaphragms. The X-ray has to be done upright for best diagnosis. This is often a surgical emergency.

X-rays for foreign bodies

Foreign bodies can be detected on an abdominal X-ray. Often these are ingested. The X-ray will show how far the foreign body has passed and if it has caused a blockage or perforation.

Blood vessel abnormalities on abdominal X-ray

An aneurysm of the aorta may sometimes be identified which may need follow up or treatment.

Vascular calcifications indicates plaque build up and atherosclerosis which can lead to bowel ischemia or not enough blood getting to bowel.

Will an abdominal X-ray show constipation?

An abdominal X-ray can show stool in the colon in various quantities.  However, constipation is mostly a clinical diagnosis that is made when bowel movements are infrequent or when there is difficulty with bowel movements.

Can abdominal X-ray show cancer?

Usually not because we do not get a detailed look inside the abdomen like we do with CT.