title: The relationship between computed tomography findings and the locations of perforated peptic ulcers: it may provide better information for gastrointestinal surgeons.
abstract: BACKGROUND
  Computed tomography (CT) plays an important role in diagnosing gastrointestinal perforation. This study explored the relationship between CT findings and the locations of perforated peptic ulcers (PPUs), which may help further surgical planning.
  
  
  METHODS
  During a 34-month period, 175 patients had CT scans. We categorized those 175 patients into 2 groups: patients with and without a PPU at a difficult ulcer site for a laparoscopic approach. Both clinical data and the CT images were reviewed and analyzed.
  
  
  RESULTS
  Based on the univariate analysis results, we conducted multivariate analyses of 3 factors: age, American Society of Anesthesiologists classification of 3 or more, and positive lesser sac image findings. The positive lesser sac findings in CT were the only independent factor that was correlated to the PPU site.
  
  
  CONCLUSIONS
  Positive lesser sac CT findings may help to predict PPUs in sites where a laparoscopic approach might be difficult. Our study re-evaluates the additional value of CT scanning in diagnosing PPU, and the results may assist with surgical planning in clinical practice.
authors: Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.
authors: Shang-Yu
authors: SY
authors: Wang
authors: Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Taoyuan, Taiwan.
authors: Chi-Tung
authors: CT
authors: Cheng
authors: Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Taoyuan, Taiwan.
authors: Chien-Hung
authors: CH
authors: Liao
authors: Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Taoyuan, Taiwan. Electronic address: drfu5564@yahoo.com.tw.
authors: Chih-Yuan
authors: CY
authors: Fu
authors: Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Yon-Cheong
authors: YC
authors: Wong
authors: Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Huan-Wu
authors: HW
authors: Chen
authors: Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Taoyuan, Taiwan.
authors: Chun-Hsiang
authors: CH
authors: Ouyang
authors: Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Taoyuan, Taiwan.
authors: I-Ming
authors: IM
authors: Kuo
authors: Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Taoyuan, Taiwan.
authors: Yu-Pao
authors: YP
authors: Hsu
authors: Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Chun-Nan
authors: CN
authors: Yeh
mesh_terms: D000368:Aged; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000000981:diagnostic imaging* / Q000601:surgery*; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Acute care surgery; CT; Computed tomography; Laparoscopic surgery; PPU; Perforated peptic ulcer