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Multidetector CT findings suggesting a perforation site in the gastrointestinal tract: analysis in surgically

Masanori Imuta1, Kazuo Awai, Yoshiharu Nakayama

  • 1Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan. hamyt@qd5.so-net.ne.jp

Radiation Medicine
|April 24, 2007
PubMed
Abstract

Insights

Multidetector computed tomography (MDCT) accurately diagnoses gastrointestinal (GI) tract perforation. This imaging technique helps identify perforation presence and location, aiding surgical planning.

Area of Science:

  • Radiology
  • Gastroenterology
  • Surgical Diagnosis

Background:

  • Gastrointestinal (GI) tract perforation is a critical surgical emergency.
  • Accurate diagnosis of perforation site is essential for timely and effective treatment.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) in determining the level of GI tract perforation.
  • To assess the utility of MDCT in identifying both the presence and specific location of GI perforations.

Main Methods:

  • Retrospective review of 155 patients with surgically confirmed GI tract perforation.
  • Analysis of eight-detector CT scans, including axial and multiplanar reconstruction (MPR) images.
  • Evaluation of direct (free air, wall rupture) and indirect (inflammation, fluid) findings on both non-contrast and contrast-enhanced MDCT.

Main Results:

  • Free air detected in over 95% of non-appendiceal perforations and 44% of appendicitis cases.
  • Direct visualization of GI tract wall rupture achieved in 32% (axial only) and 52% (axial or MPR) with contrast enhancement.
  • 90% diagnostic accuracy for perforation site achieved by integrating direct and indirect MDCT findings.

Conclusions:

  • Multidetector computed tomography (MDCT) is a valuable tool for diagnosing GI tract perforations.
  • MDCT aids in identifying the presence and precise level of GI tract perforation.
  • Combining direct and indirect findings on MDCT significantly improves diagnostic accuracy for perforation site localization.

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