Gastrointestinal perforation other imaging findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Gastrointestinal perforation Microchapters
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Overview

Fluoroscopy

• Most sensitive within the first 24 hours.
• A water-soluble agent should be used initially as barium can cause mediastinitis and can produce granulomas.
• Esophageal perforation may be represented as mucosal irregularity or gross extraluminal contrast extravasation.
• Dye studies may be useful for evaluating patients with a pleural effusion and a thoracotomy tube who are suspected to have an esophageal leak.

Suspected gastroduodenal perforation

• An upper GI study with water-soluble contrast medium is not usually the primary study for detection of a suspected gastric or duodenal perforation but can be useful for confirmation of an equivocal appearance on CT or for detection of the precise location of a small perforation.

Suspected small bowel perforation

• Small bowel follow through is inferior to CT of the abdomen and pelvis with oral contrast for detection and localization of small bowel perforation.

Chest fluroscopy shows esophageal perforation, source: Case courtesy of RMH Core Conditions, Radiopaedia.org, rID: 26313

Chest fluroscopy shows esophageal perforation, source: Case courtesy of Dr Matt A. Morgan, Radiopaedia.org, rID: 45380