title: Computed tomography attenuation values of ascites are helpful to predict perforation site.
abstract: OBJECTIVE
  To evaluate the effect of computed tomography (CT) attenuation values of ascites on gastrointestinal (GI) perforation site prediction.
  
  
  METHODS
  The CT attenuation values of the ascites from 51 patients with GI perforations were measured by volume rendering to calculate the mean values. The effect of the CT attenuation values of the ascites on perforation site prediction and postoperative complications was evaluated.
  
  
  RESULTS
  Of 24 patients with colorectal perforations, the CT attenuation values of ascites were significantly higher than those in patients with perforations at other sites [22.5 Hounsfield units (HU) vs 16.5 HU, respectively, P = 0.006]. Colorectal perforation was significantly associated with postoperative complications (P = 0.038). The prediction rate of colorectal perforation using attenuation values as an auxiliary diagnosis improved by 9.8% compared to that of CT findings alone (92.2% vs 82.4%).
  
  
  CONCLUSIONS
  The CT attenuation values of ascites could facilitate the prediction of perforation sites and postoperative complications in GI perforations, particularly in cases in which the perforation sites are difficult to predict by CT findings alone.
authors: Ryo Seishima, Koji Okabayashi, Hirotoshi Hasegawa, Masashi Tsuruta, Hiroki Hoshino, Toru Yamada, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan.
authors: Ryo
authors: R
authors: Seishima
authors: Ryo Seishima, Koji Okabayashi, Hirotoshi Hasegawa, Masashi Tsuruta, Hiroki Hoshino, Toru Yamada, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan.
authors: Koji
authors: K
authors: Okabayashi
authors: Ryo Seishima, Koji Okabayashi, Hirotoshi Hasegawa, Masashi Tsuruta, Hiroki Hoshino, Toru Yamada, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan.
authors: Hirotoshi
authors: H
authors: Hasegawa
authors: Ryo Seishima, Koji Okabayashi, Hirotoshi Hasegawa, Masashi Tsuruta, Hiroki Hoshino, Toru Yamada, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan.
authors: Masashi
authors: M
authors: Tsuruta
authors: Ryo Seishima, Koji Okabayashi, Hirotoshi Hasegawa, Masashi Tsuruta, Hiroki Hoshino, Toru Yamada, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan.
authors: Hiroki
authors: H
authors: Hoshino
authors: Ryo Seishima, Koji Okabayashi, Hirotoshi Hasegawa, Masashi Tsuruta, Hiroki Hoshino, Toru Yamada, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan.
authors: Toru
authors: T
authors: Yamada
authors: Ryo Seishima, Koji Okabayashi, Hirotoshi Hasegawa, Masashi Tsuruta, Hiroki Hoshino, Toru Yamada, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan.
authors: Yuko
authors: Y
authors: Kitagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000000981:diagnostic imaging* / Q000209:etiology; D003106:Colon / Q000000981:diagnostic imaging* / Q000293:injuries; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D012007:Rectum / Q000000981:diagnostic imaging* / Q000293:injuries; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
keywords: Ascites; Computed tomography attenuation value; Gastrointestinal perforation; Perforation site prediction; Volume rendering method