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Accuracy of MDCT in Predicting Site of Gastrointestinal Tract Perforation

Bernard Hainaux1,2, Emmanuel Agneessens2, Raphael Bertinotti1, Viviane De Maertelaer3, Erika Rubesova1, Elie Capelluto4 and Constantin Moschopoulos1

1 Department of Radiology, Centre Hospitalier Universitaire St.-Pierre, Université Libre de Bruxelles, 322 Rue Haute, Brussels 1000, Belgium.
2 Department of Radiology, HIS Site Etterbeek-Ixelles, Brussels, Belgium.
3 Statistical Unit, Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire, Université Libre de Bruxelles, Brussels, Belgium.
4 Department of Gastrointestinal Surgery, Centre Hospitalier Universitaire St.-Pierre, Université Libre de Bruxelles, Brussels, Belgium.


Figure 1
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  		Fig. 1A —69-year-old man presenting with acute abdominal pain few hours after sigmoid polypectomy. Abdominal CT scan obtained at level of liver shows free intraperitoneal air.

 

Figure 2
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  		Fig. 1B —69-year-old man presenting with acute abdominal pain few hours after sigmoid polypectomy. Image at level of sigmoid shows concentration of extraluminal air bubbles in close proximity to sigmoid wall (arrows).

 

Figure 3
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  		Fig. 2A —51-year-old woman with perforated gastric ulcer. Transverse CT image shows pneumoperitoneum (asterisks) and focal defect in anterior gastric wall (arrow).

 

Figure 4
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  		Fig. 2B —51-year-old woman with perforated gastric ulcer. Sagittal reformatted image shows focal defect in anterior wall of gastric fundus (arrow) and pneumoperitoneum (asterisk).

 

Figure 5
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  		Fig. 3 —42-year-old man with perforated sigmoid colon diverticulitis. Transverse CT image shows segmental bowel-wall thickening (arrowheads), mild pericolic fat stranding (asterisk), and few extraluminal bubbles of air adjacent to the bowel wall (arrow).

 

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