Abdominal XRay Air as a Contrast Agent

The plain film of the abdomen is still very useful in the evaluation of the neonate. Air can be used as a contrast agent since newborns will start swallowing air immediately after birth, and gas should be present in the stomach within minutes. After 3 h, air should be seen throughout the entire small bowel, while the sigmoid colon is seen after 8-9 h (Berrocal et al. 1999). Some congenital anomalies can be readily diagnosed without the need for other contrast media (Fig. 3.2), for instance a duodenal obstruction with the typical "double-bubble" appearance, which may be caused for instance by duodenal atresia or midgut volvulus.

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