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Old 04-21-2011
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X Ray Imperforate anus x-ray

When taking the X ray of a child with imperforate anus, why is it that the child has to be held upside down?

With the metal marker taped on his/her imperforate anus, won't it be easier to view the distance from the impeforate rectum/anus till the atretic end of the bowel, if the air in the bowel was allowed to push till the end where it becomes atretic/malformed? if the child is held upside down, then the air goes back up towards the smaller intestine right?

and the child is not literally held upside down is he? I've seen x rays and they are all placed on their anterior abdomen with their knees-in-chest position so that their backs are lifted on a slant.
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Old 04-21-2011
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You have to elevate the anorectal area of the baby so that you get the rectal gas reach as far as it can so that you can then see that it's not reaching the anal area.

Yes, they don't literally hold the child upside down, they just put him knee/chest position.

See this;

Imperforate anus x-ray-800px-atresia.jpg
click image to enlarge
Image from Wikimedia, link; http://en.wikipedia.org/wiki/File:Atresia.jpg
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Old 04-21-2011
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I think air reaches upto the highest point it is allowed to reach....it should not be pushed back into the small bowel on putting the child upside down, rather should go up to atretic segment...
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Old 04-22-2011
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hmm,..yes i see it now. air is lighter so it travels up. i was thinking about how we should wait 18hrs before xray-ing a child because we need to see how far the air travels down till it cant anymore as soon as the child is born and swallowing air. so in my head i was thinking tht when he is lying down, the air gets the travel down, but when his anorectal area is lifted, it doesnt.

but i see ur explanations now.

thx guys.
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Gastroenterology-, Pediatrics-, Radiographs-, Radiology-, Surgery-

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