Neda Yagan1, Yong H Auh, Andrea Fisher. 1. Department of Radiology, New York Presbyterian Hospital-Weill Cornell Medical Center, 525 E 68th St, Room L023, New York, NY 10065, USA. ney2001@med.cornell.edu
Abstract
PURPOSE: To determine the extraperitoneal distribution of air following perforation of the second portion of the duodenum. MATERIALS AND METHODS: Institutional review board approval was obtained for this HIPAA-compliant study. The requirement for written informed consent was waived. Two reviewers who were aware of the presence of duodenal perforation after duodenal endoscopy retrospectively reviewed computed tomographic (CT) images in eight patients (one man, seven women; mean age, 68 years; age range, 27-88 years) to assess and categorize the location of extraluminal air. RESULTS: Extraluminal air was detected in the following locations: right anterior pararenal space (n = 8), right perirenal space (n = 7), right posterior pararenal space (n = 4), right properitoneal compartment (n = 4), bare area of the liver (n = 6), right extraperitoneal pelvis (n = 7), hepatoduodenal ligament (n = 3), mesentery (n = 2), mediastinum (n = 4), portal venous system (n = 1), and peritoneal cavity (n = 1). CONCLUSION: Air extended posteriorly into the right perirenal space in seven (88%) of eight patients following perforation of the second portion of the duodenum. Duodenal perforation introduces potential for direct communication between the right anterior pararenal space and the right perirenal space. SUPPLEMENTAL MATERIAL: http://radiology.rsnajnls.org/cgi/content/full/2503080605/DC1. RSNA, 2009
PURPOSE: To determine the extraperitoneal distribution of air following perforation of the second portion of the duodenum. MATERIALS AND METHODS: Institutional review board approval was obtained for this HIPAA-compliant study. The requirement for written informed consent was waived. Two reviewers who were aware of the presence of duodenal perforation after duodenal endoscopy retrospectively reviewed computed tomographic (CT) images in eight patients (one man, seven women; mean age, 68 years; age range, 27-88 years) to assess and categorize the location of extraluminal air. RESULTS: Extraluminal air was detected in the following locations: right anterior pararenal space (n = 8), right perirenal space (n = 7), right posterior pararenal space (n = 4), right properitoneal compartment (n = 4), bare area of the liver (n = 6), right extraperitoneal pelvis (n = 7), hepatoduodenal ligament (n = 3), mesentery (n = 2), mediastinum (n = 4), portal venous system (n = 1), and peritoneal cavity (n = 1). CONCLUSION: Air extended posteriorly into the right perirenal space in seven (88%) of eight patients following perforation of the second portion of the duodenum. Duodenal perforation introduces potential for direct communication between the right anterior pararenal space and the right perirenal space. SUPPLEMENTAL MATERIAL: http://radiology.rsnajnls.org/cgi/content/full/2503080605/DC1. RSNA, 2009