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Perforation of the mesenteric small bowel: etiologies and CT findings

John Hines1, Juliana Rosenblat, Dameon R Duncan

  • 1Department of Radiology, Long Island Jewish Medical Center, 270-05 76th Ave, New Hyde Park, NY 11040, USA. jhines@nshs.edu

Emergency Radiology
|December 6, 2012
PubMed

Insights

Small bowel perforation, an uncommon cause of acute abdomen, has diverse origins globally. Abdominal CT imaging is crucial for diagnosing perforation and identifying its specific cause, aiding prompt treatment.

Area of Science:

  • Gastroenterology
  • Radiology
  • Abdominal Imaging

Background:

  • Mesenteric small bowel perforation is an uncommon but serious cause of acute abdominal pain.
  • Etiologies vary significantly between underdeveloped and industrialized nations.
  • Computed tomography (CT) is the primary imaging modality for acute abdominal conditions.

Purpose of the Study:

  • To review the diverse causes of mesenteric small bowel perforation.
  • To illustrate and discuss the characteristic findings on abdominal CT scans.
  • To aid radiologists in diagnosing the etiology of small bowel perforation.

Main Methods:

  • Pictorial essay format.
  • Review of literature on small bowel perforation etiologies.
  • Illustration of CT findings associated with various causes.

Main Results:

  • Infection is a common cause in underdeveloped countries.
  • Industrialized nations see causes including Crohn disease, diverticulitis, foreign bodies, trauma, tumors, obstruction, ischemia, and iatrogenic factors.
  • CT findings, though sometimes subtle, are key to identifying the cause of perforation.

Conclusions:

  • Abdominal CT is highly sensitive for detecting small bowel perforation.
  • Recognizing subtle CT findings can help differentiate between various etiologies.
  • Accurate diagnosis of perforation cause via CT is essential for appropriate patient management.

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