From esophagus to rectum: A comprehensive review of alimentary tract perforations at computed tomography

Andrew J. Del Gaizo, Chandana Lall, Brian C. Allen, John R. Leyendecker

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Gastrointestinal (GI) tract perforation is a life-threatening condition that can occur at any site along the alimentary tract. Early perforation detection and intervention significantly improves patient outcome. With a high sensitivity for pneumoperitoneum, computed tomography (CT) is widely accepted as the diagnostic modality of choice when a perforated hollow viscus is suspected. While confirming the presence of a perforation is critical, clinical management and surgical technique also depend on localizing the perforation site. CT is accurate in detecting the site of perforation, with segmental bowel wall thickening, focal bowel wall defect, or bubbles of extraluminal gas concentrated in close proximity to the bowel wall shown to be the most specific findings. In this article, we will present the causes for perforation at each site throughout the GI tract and review the patterns that can lead to prospective diagnosis and perforation site localization utilizing CT images of surgically proven cases.

Original languageEnglish (US)
Pages (from-to)802-823
Number of pages22
JournalAbdominal Imaging
Volume39
Issue number4
DOIs
StatePublished - Aug 2014

Keywords

  • Computed tomography
  • Gastrointestinal
  • Perforation

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

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