CT of acute gastrointestinal disorders

The evaluation of acute gastrointestinal disorders is a challenging task for both the clinician and the radiologist. Such disorders frequently are nonspecific in their presentation, often mimicking a variety of other acute abdominal disorders. No imaging test can provide a specific diagnosis in all circumstances. The choice of the initial imaging study for a particular presentation involves a compromise between various factors, including availability, safety, cost, clinical stability of the patient, the effect on other diagnostic tests and therapeutic maneuvers that may need to be performed, and the likelihood that the imaging method will provide at least some information localizing and characterizing the disorder. CT is not inexpensive, nor is it as rapidly performed as plain film radiography. Its spatial resolution limits its applicability in detection of gastrointestinal mucosal disease, fistulous tracts, and small vessel abnormalities. On the other hand, it is a powerful method to evaluate the full extraluminal extent of gastrointestinal abnormalities and to detect abnormalities of extraenteric organs and tissues. In some circumstances, such as trauma and suspected abdominal abscess, CT should probably be the initial imaging test. Also, when other imaging tests are nonrevealing, CT can provide valuable information and often suggest a clinically unsuspected gastrointestinal abnormality.