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| ==Overview== | | ==Overview== |
| CT may be positive in unto 82%. CT may be indicated in all patients with acute abdomen. However, CT can be omitted when a diagnosis is made according to the results of precedent examinations such as US. Radiation exposure should be considered with the use of CT. | | [[CT scan]] may be useful in the evaluation of [[cirrhosis]] and its complications. |
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| ==Key CT Findings in Secondary peritonitis== | | ==CT == |
| *Contrast-enhanced CT is useful in identifying an intraabdominal source for infection. | | *[[CT scan]] may be useful in the evaluation of [[cirrhosis]] and its complications. |
| * If the diagnosis of peritonitis is made clinically, a CT scan is not necessary and generally delays surgical intervention without offering clinical advantage.
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| * However, CT scanning is indicated in all cases in which the diagnosis cannot be established on clinical grounds and findings on abdominal plain films.
| | ![[Image:Perforated-gallbladder-with-bile-peritonitis.jpg|800|thumb|CT scan with contrast enhancement showing perforated gall bladder, surrounding peritoneum shows abnormally increased enhancement - Case courtesy of Dr Nasir Siddiqui, Radiopaedia.org, rID: 12265]] |
| * CT scans of the abdomen and pelvis remain the diagnostic study of choice for peritoneal abscess and related visceral pathology.
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| * Whenever possible, the CT scan should be performed with enteral and intravenous contrast.
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| * CT scans can detect small quantities of fluid, areas of inflammation, and other GI tract pathology, with sensitivities that approach 100%.
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| * CT scanning can be used to evaluate for ischemia, as well as to determine bowel obstruction.
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| * An abscess is suggested by the presence of fluid density that is not bound by the bowel or other known structures.
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| * Gas within an abdominal mass or the presence of an enhancing wall and adjacent inflammatory changes are also highly suggestive of an abscess.
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| * Ischemia can be demonstrated by a clot in a large vessel or by the absence of blood flow.
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| * Gas within the intestinal wall or in the [[portal vein]] may also suggest [[ischemia]].
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| * Enhanced CT is recommended for the evaluation of organ ischemia, vascular lesions, or acute [[Acute pancreatitis|pancreatitis]] severity.
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| * CT has high diagnosability for [[intestinal ischemia]], [[gastrointestinal perforation]], [[acute appendicitis]], [[diverticulitis]], biliary tract [[calculus]], and acute pancreatitis among others. However, these diseases cannot be completely ruled out, even if abnormalities are not found on CT.
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| * In patients taking a biguanide for diabetes, attention must be paid to the potential onset of lactic acidosis after iodinated contrast media administration .
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| * CT is also recommended for detecting intra-abdominal free air.
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| ==CT Examples of Secondary peritonitis==
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| ==References== | | ==References== |
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| | [[Category:Emergency mdicine]] |
| | [[Category:Disease]] |
| | [[Category:Up-To-Date]] |
| | [[Category:Infectious disease]] |
| | [[Category:Gastroenterology]] |
| | [[Category:Surgery]] |
