How to Use Compression Radiography

Compression radiography is used for the abdomen to displace intestinal structures away from regions or organs of interest. Bowel is often superimposed with other organs or even with itself and prevents us from being able to identify organs clearly. Examples are bowel superimposed with the kidneys or bladder. Other examples are intestines that are superimposed with one another and, due to gas or other content, make it difficult to investigate individual bowel segments for foreign bodies or masses. By compressing the abdomen, bowel can be displaced so that underlying structures can be well visualized. Specific examples include: displacing bowel from the kidneys or bladder to identify urolithiasis, displacing bowel to assess a single segment's size, shape, and content (foreign body content, linear foreign body plication).

Technique

Left and right lateral recumbent and VD radiographs of the abdomen should be performed prior to compression radiography. A wooden spoon with a long handle is used to gently press down on the abdomen in the region of interest. The individual performing the procedure must follow radiation safety practices with lead apron, thyroid shield, and lead-gloved hand. Starting in lateral recumbency, the cranial and then caudal abdomen is compressed by placing the spoon on the non-dependent side of the abdomen and exposing the radiography during compression. On the V image, the wooden spoon can be placed at the right or left side, cranially and caudally and pressed down toward the spine in the region of interest (kidney, spleen, uterus region).

Compression radiography is a valuable technique that is easy, inexpensive, and very valuable in diagnosing intestinal abnormalities and for eliminating superimposition of the urinary tract to identify urolithiasis. For intestinal obstruction, common abnormalities are granular content in the lumen of solitary jejunal or duodenal segments. Linear foreign bodies can be easily identified by their plicated or tortuous course.