The two previous images were initial scout images prior to a CT scan. We do not routinely do lateral radiographs of the abdomen, but we do often do a lateral view for localization prior to a CT scan. The abdomen is markedly distended, and given the patient history, this might suggest liver failure with ascites, but the acute pain should also suggest pancreatitis.

What are the technical differences between the two studies shown here on this same patient? What is the most striking finding? What do you think of the pancreas? The blue link below will bring up the ACR recommendations for imaging in pancreatitis.