The features of perforated peptic ulcers in conventional computed tomography.
OBJECTIVE
CT is not usually of priority to evaluate the pathology of the gastrointestinal tract, especially perforated peptic ulcer. However CT might be employed when the presentation is atypical. The study was to summarize the imaging features of perforated peptic ulcer in conventional CT and assess its ability of detecting perforated peptic ulcer.


METHODS
The CTs of 14 consecutive patients with perforated peptic ulcer confirmed by operation were retrospectively reviewed. The CTs were obtained after intravenous contrast medium, but oral contrast medium was administered only in 5 patients. The CT findings were correlated with surgical findings.


RESULTS
Among these 14 patients, all the 14 patients (100%) had extraluminal air accumulation, 10 patients (71%) had abnormal fluid accumulation, and 5 (36%) patients had inflammatory changes in surrounding soft tissues. In addition, conventional CT could only demonstrate the site of perforation in 5 patients (36%) of them.


CONCLUSIONS
Conventional CT was valuable in the diagnosis of perforated peptic ulcer, and pneumoperitoneum was the most common feature. However the ability of conventional CT in localizing the site of perforation was poor.
Chen
C H
CH
Division of Gastroenterology, Department of Internal Medicine, Changhua Show-Chwan Memorial Hospital, 542, Sec 1, Chung-Shang Rd, Changhua, Taiwan 500, ROC.
Huang
H S
HS
Yang
C C
CC
Yeh
Y H
YH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004381:Duodenal Ulcer / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000000981:diagnostic imaging* / Q000601:surgery; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging / Q000601:surgery; D012680:Sensitivity and Specificity; D013276:Stomach Ulcer / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed
D003287:Contrast Media