title: Gastrointestinal tract perforation: CT diagnosis of presence, site, and cause.
abstract: Gastrointestinal tract perforation is an emergent condition that requires prompt surgery. Diagnosis largely depends on imaging examinations, and correct diagnosis of the presence, level, and cause of perforation is essential for appropriate management and surgical planning. Plain radiography remains the first imaging study and may be followed by intraluminal contrast examination; however, the high clinical efficacy of computed tomographic examination in this field has been well recognized. The advent of spiral and multidetector-row computed tomographic scanners has enabled examination of the entire abdomen in a single breath-hold by using thin-slice sections that allow precise assessment of pathology in the alimentary tract. Extraluminal air that is too small to be detected by conventional radiography can be demonstrated by computed tomography. Indirect findings of bowel perforation such as phlegmon, abscess, peritoneal fluid, or an extraluminal foreign body can also be demonstrated. Gastrointestinal mural pathology and associated adjacent inflammation are precisely assessed with thin-section images and multiplanar reformations that aid in the assessment of the site and cause of perforation.
authors.affiliation: Department of Radiology, Shiga University of Medical Science, Seta Tsukinowa-cho Otsu, Shiga 520-2192, Japan. akira@belle.shiga-med.ac.jp
authors.forename: A
authors.initials: A
authors.lastname: Furukawa
authors.forename: M
authors.initials: M
authors.lastname: Sakoda
authors.forename: M
authors.initials: M
authors.lastname: Yamasaki
authors.forename: N
authors.initials: N
authors.lastname: Kono
authors.forename: T
authors.initials: T
authors.lastname: Tanaka
authors.forename: N
authors.initials: N
authors.lastname: Nitta
authors.forename: S
authors.initials: S
authors.lastname: Kanasaki
authors.forename: K
authors.initials: K
authors.lastname: Imoto
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
authors.forename: K
authors.initials: K
authors.lastname: Murata
authors.forename: T
authors.initials: T
authors.lastname: Sakamoto
authors.forename: T
authors.initials: T
authors.lastname: Tani
mesh_terms: D001466:Barium Sulfate; D003287:Contrast Media; D003937:Diagnosis, Differential; D004630:Emergencies; D004733:Enema; D005119:Extravasation of Diagnostic and Therapeutic Materials; D006801:Humans; D033162:Incidental Findings; D007416:Intestinal Perforation / Q000000981:diagnostic imaging* / Q000209:etiology; D010439:Peptic Ulcer Perforation / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate