Abstract
The purpose of this study is to review the computed tomography (CT) appearance of
gastrointestinal tract (GI) perforation. Forty-two patients with 10 cases of proximal
GI perforation and 32 cases of distal GI perforation were evaluated based on the CT
findings of extraluminal air (which was subdivided into the CT-falciform ligament
sign crossing the midline and scattered pockets of air), bowel wall thickening (>8
mm in gastroduodenal wall, >3 mm in the small bowel wall, >6 mm in the caliber of
the appendix and >5 mm in the colonic wall), associated abscess formation, ascites
and adjacent fat stranding. The results were compared using Fisher's Exact Test. Detection
of extraluminal air in the upright plain films and CT was analyzed by Z test. Our results showed that CT-falciform ligament sign was more frequent in the
proximal GI perforation, while pockets of extraluminal air (excluding the cases accompanying
CT-falciform ligament sign), bowel wall thickening and fat stranding were found in
higher incidence in distal GI perforation (P<.05). CT detected extraluminal air in more cases than the upright plain films did
(69% vs. 19%; Z=4.62>Z0.01=2.326). We concluded that CT is a good imaging tool to differentiate the various
GI perforations.
Keywords
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Article info
Publication history
Received:
June 1,
2003
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
