title: Multidetector CT diagnosis of non-traumatic gastroduodenal perforation.
abstract: BACKGROUND
  To identify reliable CT features and assess the diagnostic performance of 64-multidetector CT (MDCT) in diagnosing non-traumatic gastroduodenal perforation (GDP).
  
  
  METHODS
  We retrospectively reviewed 136 CT scans of patients with surgically proven non-traumatic gastrointestinal perforation during 7 years. 92 patients had GDP and 44 patients had other sites of perforation. CT features of perforation were evaluated and the sensitivity, specificity and likelihood ratios of each CT feature were estimated.
  
  
  RESULTS
  The cause of GDP was peptic ulcer in 90 patients, gastric cancer in one patient, and foreign body of duodenal diverticulum in one patient. Extraluminal gas (97%) was most common CT feature of GDP, following by fluid or fat strand along gastroduodenum (89%), ascites (89%), wall defect and/or ulcer (84%), and wall thickening (72%). Of CT features, wall defect and/or ulcer showed the best positive likelihood ratios for GDP (36.83). Wall thickening also showed high positive likelihood ratios (10.52). Combined, these CT features showed 95% sensitivity and 93% specificity for localization of perforation site of GDP.
  
  
  CONCLUSIONS
  MDCT is useful in diagnosis of presence and site of GDP. Wall defect and/or ulcer and wall thickening have a high positive predictive value for localization of perforation site.
authors.affiliation: Department of Radiology, Dankook University Hospital, Cheonan, South Korea.
authors.forename: Dabee
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Radiology, Dankook University Hospital, Cheonan, South Korea.
authors.forename: Mi-Hyun
authors.initials: MH
authors.lastname: Park
authors.affiliation: Department of Radiology, Chungnam National University Hospital, Daejeon, South Korea.
authors.forename: Byung Seok
authors.initials: BS
authors.lastname: Shin
authors.affiliation: Department of Radiology, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam, South Korea.
authors.forename: Gyeong Sik
authors.initials: GS
authors.lastname: Jeon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000706:statistics & numerical data*; D010437:Peptic Ulcer / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D010439:Peptic Ulcer Perforation / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015995:Prevalence; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012680:Sensitivity and Specificity
keywords: intestines; multidetector computed tomography; peptic ulcer; perforation