Gastrointestinal perforation CT

[{CMG}}; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[1]

Overview

Chest CT

• When fluoroscopy is equivocal, and there is persisting suspicion of perforation. 2, 4
• Pleural or mediastinal fluid
• Pneumomediastinum or pneumothorax

Abdominal CT

• Signs of perforation on abdominal CT scanning include:
• Extraluminal oral contrast
• free fluid or food collections
• discontinuity of the intestinal wall
• localized peritoneal fat stranding
• bowel wall thickening
• oral contrast, then often the leak can be seen directly as contrast spills out of the perforation site
• fistula
• intra-abdominal abscess
• [82,93,99,100].

Intestinal perforation CT, source: Case courtesy of Dr Ian Bickle, Radiopaedia.org, rID: 47152

CT shows large bowel perforation, source: Case courtesy of Dr Ian Bickle, Radiopaedia.org, rID: 55375