Extension of air into the right perirenal space after duodenal perforation: CT findings.
OBJECTIVE
To determine the extraperitoneal distribution of air following perforation of the second portion of the duodenum.


METHODS
Institutional review board approval was obtained for this HIPAA-compliant study. The requirement for written informed consent was waived. Two reviewers who were aware of the presence of duodenal perforation after duodenal endoscopy retrospectively reviewed computed tomographic (CT) images in eight patients (one man, seven women; mean age, 68 years; age range, 27-88 years) to assess and categorize the location of extraluminal air.


RESULTS
Extraluminal air was detected in the following locations: right anterior pararenal space (n = 8), right perirenal space (n = 7), right posterior pararenal space (n = 4), right properitoneal compartment (n = 4), bare area of the liver (n = 6), right extraperitoneal pelvis (n = 7), hepatoduodenal ligament (n = 3), mesentery (n = 2), mediastinum (n = 4), portal venous system (n = 1), and peritoneal cavity (n = 1).


CONCLUSIONS
Air extended posteriorly into the right perirenal space in seven (88%) of eight patients following perforation of the second portion of the duodenum. Duodenal perforation introduces potential for direct communication between the right anterior pararenal space and the right perirenal space.


BACKGROUND
http://radiology.rsnajnls.org/cgi/content/full/2503080605/DC1.
Yagan
Neda
N
Department of Radiology, New York Presbyterian Hospital-Weill Cornell Medical Center, 525 E 68th St, Room L023, New York, NY 10065, USA. ney2001@med.cornell.edu
Auh
Yong H
YH
Fisher
Andrea
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D004386:Duodenum / Q000000981:diagnostic imaging* / Q000293:injuries*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging*; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*