Value of abdominal radiograph in the follow-up of spinal cord injury patients

Tins _et al_,1 in an article published recently in _Spinal Cord_, state that the KUB radiograph does not seem justified in the routine follow-up of the urinary tract in spinal injury

patients. Patients, who had sustained spinal cord injury, attend the spinal unit for _global_ check-up; these patients do not come to the spinal unit for an assessment of the urinary tract

alone. X-ray of the KUB or abdominal radiograph represents one of the many tests of surveillance carried out during a follow-up visit to the spinal injuries centre. We found the abdominal

radiograph to provide valuable information about bowel gas pattern, faecal loading, redundant sigmoid loop, dilated large bowel especially the caecum, presence of spinal curvature, vascular

calcification, gall stones, pancreatic calcification, Charcot's spine, and status of hip joints in addition to the presence of any radio-opaque calculi in the urinary tract. Dysfunction

of bowels in spinal cord injury patients causes considerable morbidity and, rarely, mortality as well. Redundant sigmoid bowel was noted during a routine follow-up of a patient with C-4

tetraplegia. About 6 months later, this patient developed sigmoid volvulus and succumbed to respiratory complications in a local district general hospital. Since then we tend to be proactive

in treating patients with redundant sigmoid colon. Similarly, we consider total colectomy as one of the options for managing globally dilated large bowel in a tetraplegic patient, in whom

the distended colon causes compromise to lung function because of the sheer volume occupied by the large bowel, which has gaseous distension and faecal loading. Abdominal distension and

consequent upward displacement of domes of the diaphragm in tetraplegic subjects lead to a significant reduction in lung volumes, which often results in desaturation (hypoxaemia). In

conclusion, we believe that the abdominal radiograph provides valuable information, especially regarding the status of the neuropathic bowel, and should not be omitted during annual

follow-up visits of spinal cord injury patients. REFERENCES * Tins B, Teo HG, Popuri R, Cassar-Pullicino V, Tyrrell P . Follow-up imaging of the urinary tract in spinal injury patients: is a

KUB necessary with every ultrasound? _Spinal Cord_ 2005; 43: 219–222. Article  CAS  Google Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * North-West Regional

Spinal Injuries Centre, District General Hospital, Southport, PR8 6PN, UK S Vaidyanathan & B M Soni * Department of Radiology, District General Hospital, Southport, PR8 6PN, UK P L

Hughes Authors * S Vaidyanathan View author publications You can also search for this author inPubMed Google Scholar * B M Soni View author publications You can also search for this author

inPubMed Google Scholar * P L Hughes View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE

CITE THIS ARTICLE Vaidyanathan, S., Soni, B. & Hughes, P. Value of abdominal radiograph in the follow-up of spinal cord injury patients. _Spinal Cord_ 44, 63 (2006).

https://doi.org/10.1038/sj.sc.3101766 Download citation * Published: 19 July 2005 * Issue Date: 01 January 2006 * DOI: https://doi.org/10.1038/sj.sc.3101766 SHARE THIS ARTICLE Anyone you

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