Note also that this abdominal film is not guaranteed to be normal. Note that the renal, liver, psoas muscles and urinary bladder outlines are visualised This patient has a gasless rather than featureless abdomen. A featureless abdomen can be a result of tumour or ascites. Most texts quote a more conservative figure (2 is common).ĭon't confuse gasless with featureless. Some texts will claim that up to seven fluid levels in the small bowel on an erect abdominal film can be normal. If the patient is air-swallowing at a higher rate than the small bowel can absorb the air, it will be visualised in the bowel. Some people habitually air-swallow while others air-swallow at times of stress or when they are in pain. Gas enters the small bowel during eating and drinking. There is debate regarding what is a normal amount of small bowel gas. Fluid-filled loops of small bowel are present but are never as well visualised as air-filled loops. This patient appears to have a gasless small bowel. Equally, a check of the patient history may reveal relevant information such as total colectomy. However, consideration should be given to the possibility of a gasless obstruction. Gas in the large bowel can be endogenous, resulting from fermentation processes of faecal material.Īn absence of gastrointestinal gas on abdominal plain film is not specifically abnormal (but is suspect). Some patients habitually air swallow or may air-swallow when in pain. Firstly, gas in the stomach and small bowel can be ingested with food. Gas in the gastrointestinal tract can commonly accumulate from two sources. This page examines the difference between gasless and featureless patterns and their significance.Ī gasless abdominal plain film refers to an absence or minimum of gas in the gastrointestinal tract.Ī featureless abdominal plain film is one in which there is little or no visualisation of the normal abdominal viscera.
Gasless and featureless abdominal plain films have a 'look of the abnormal'.
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