X-ray Abdominal Invertogram, Preparation, Procedure, and the Requirements

28 Oct 2022

X-ray Abdominal Invertogram, Preparation, Procedure, and the Requirements

An x-ray abdominal invertogram is a specific sort of abdominal x-ray performed on infants. It is used to find out the severity of anal or rectal atresia. Atresia is when the passageway in the body is blocked or non-existing.

This view is to indicate the distance between the gas bubble in the terminal colon and the perineal skin and allows the classification of anal atresia in neonates. The image is usually obtained 24 hours after birth, to allow for small fistulas to become clear.


* Anal atresia

* Rectal atresia

* Distended abdomen

* Imperforate anus

Patient Preparation

* Patient is held from their lower limbs

* No hips and shoulders rotation

* Remove any radiopaque items such as ECG dots, diapers, shiny decorative clothing

* Take the x-ray with full inspiration

* A radiopaque marker i.e coin is placed over the expected anus using radiolucent tape

Technical Factors

  • * Lateral projection
  • * Suspended inspiration (on observation)
  • * Cantering point
  • The mid-coronal plane at the level of the iliac crest
  • Collimation
  • Superior to the diaphragm
  • Inferior to the rectum
  • Antero-posterior to include soft tissue edge
  • Orientation
  • Portrait
  • Detector size
  • Will vary depending on the child’s body habitus
  • Exposure  3
  • 60-75 kvp
  • 3-10 mas
  • SID
  • 100 cm
  • Grid
  • No

Image Technical Evaluation

* It should be possible to find out the distance between the air-filled distal rectal pouch and the anal dimple

* The abdomen must be free from rotation

* There should not be blurring of the bowel gas from respiratory motion is ideal