PURPOSE: The purpose of this study was to evaluate the computed tomography (CT) signs of free and covered small-bowel perforations and the potential of CT in recognising the aetiology. MATERIALS AND METHODS: Thirty-five patients with surgically proven small-bowel perforation were retrospectively evaluated. Fundamental signs (extraluminal air, solution of continuity) and secondary signs (thickening of the mesentery, free or perilesional fluid, wall thickening) were considered. RESULTS: CT alterations were found in 31/35 (88.6%) patients: extraluminal air (30/35, 85.7%), solution of continuity (11/35, 31.4%), intra-abdominal fluid (27/35, 77.1%), thickening of the mesentery (20/35, 57.1%), and wall thickening (14/35, 40%). In 25/35 cases (71.4%) pneumoperitoneum was detected, associated with secondary signs (23/25, 82%), confirmed as free perforations at surgery. In 5/35 patients (14.2%), peri-intestinal air bubbles and secondary signs were evident, while in 1/35 cases (2.8%) only secondary signs were seen, namely covered perforations. In 4/35 patients (11.4%) with a covered perforation, the CT scan was negative. The nature of the perforations was completely recognisable in 26/31 cases (83.9%), partially identifiable in 4/31 (12.9%), not evident in 1/31 (3.2%). CONCLUSION: CT investigation is essential in the recognition of a small-bowel perforation and in the definition of its nature.
PURPOSE: The purpose of this study was to evaluate the computed tomography (CT) signs of free and covered small-bowel perforations and the potential of CT in recognising the aetiology. MATERIALS AND METHODS: Thirty-five patients with surgically proven small-bowel perforation were retrospectively evaluated. Fundamental signs (extraluminal air, solution of continuity) and secondary signs (thickening of the mesentery, free or perilesional fluid, wall thickening) were considered. RESULTS: CT alterations were found in 31/35 (88.6%) patients: extraluminal air (30/35, 85.7%), solution of continuity (11/35, 31.4%), intra-abdominal fluid (27/35, 77.1%), thickening of the mesentery (20/35, 57.1%), and wall thickening (14/35, 40%). In 25/35 cases (71.4%) pneumoperitoneum was detected, associated with secondary signs (23/25, 82%), confirmed as free perforations at surgery. In 5/35 patients (14.2%), peri-intestinal air bubbles and secondary signs were evident, while in 1/35 cases (2.8%) only secondary signs were seen, namely covered perforations. In 4/35 patients (11.4%) with a covered perforation, the CT scan was negative. The nature of the perforations was completely recognisable in 26/31 cases (83.9%), partially identifiable in 4/31 (12.9%), not evident in 1/31 (3.2%). CONCLUSION: CT investigation is essential in the recognition of a small-bowel perforation and in the definition of its nature.
Authors: A Furukawa; M Sakoda; M Yamasaki; N Kono; T Tanaka; N Nitta; S Kanasaki; K Imoto; M Takahashi; K Murata; T Sakamoto; T Tani Journal: Abdom Imaging Date: 2005 Sep-Oct
Authors: V Maniatis; H Chryssikopoulos; A Roussakis; C Kalamara; S Kavadias; A Papadopoulos; J Andreou; K Stringaris Journal: Abdom Imaging Date: 2000 Jul-Aug