Multidetector-row CT findings of colonic perforation: direct visualization of ruptured colonic wall

Miki, T; Ogata, Seiji; Uto, Mitsunobu; Nakazono, Toshihiro; Urata, Miyuki; Ishibe, Ryouhei; Shinyama, Shin; Nakajo, Masayuki

doi:10.1007/s00261-003-0159-y

Cited by 40 publications

(21 citation statements)

References 13 publications

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“…In addition, thickening of the duodenal wall was not seen in the false positive DF case, whereas this finding was present in most true positive cases of duodenal perforation (94.7%; 18 of 19 cases). Several authors have described the importance of bowel wall thickening [16][17][18][19]. Thus, the combination of DF and thickening of the duodenal wall is presumed to be important for correctly identifying the perforation site.…”

Section: Discussionmentioning

confidence: 95%

“…a direct finding (DF), could be visualised using multidetector CT (MDCT) [16][17][18]. The DF of a ruptured GI tract wall is more reliable for determining the perforation site, compared with CFs; however, according to previous reports, the sensitivity of detecting a ruptured GI tract wall was not particularly high using 4-or 8-slice MDCT (40-52%) [16][17][18][19][20]. Another study using 8-and 16-MDCT also reported the low sensitivity of 53% [21].…”

Section: Introductionmentioning

confidence: 99%

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64-slice multidetector computed tomography evaluation of gastrointestinal tract perforation site: detectability of direct findings in upper and lower GI tract

Oguro

Funabiki²,

Hosoda³

et al. 2009

Eur Radiol

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

64-slice multidetector computed tomography evaluation of gastrointestinal tract perforation site: detectability of direct findings in upper and lower GI tract

Oguro

Funabiki²,

Hosoda³

et al. 2009

Eur Radiol

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“…Other CT findings observed in colonic perforation are of a complex mass, inflammatory change, an extraluminal fluid collection, and bowel wall thickening around the perforation site. 2,33 Occasionally, a sigmoid diverticulum can perforate into the mesosigmoid, with gas tracking into the retroperitoneum.…”

Section: Colonic Perforationmentioning

confidence: 99%

Evolution of imaging for abdominal perforation

Singh

Steward

Booth

et al. 2010

annals

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INTRODUCTION Gastrointestinal (GI) perforation is a common surgical presentation. In recent years, computed tomography (CT) has been shown to be accurate for predicting the site of GI perforation, and has become the investigation of choice. However the signs may be subtle or only indirectly related to the site or aetiology of perforation. SUBJECTS AND METHODS A MEDLINE and PubMed search was performed for journals before June 2009 with MeSH major terms 'CT' and 'perforation'. Non-English speaking literature was excluded. RESULTS Examples of GI perforation of various aetiologies are reviewed (inflammatory, neoplastic, traumatic and iatrogenic) high-lighting characteristic CT appearances as well as pitfalls in diagnosis. Features of perforation include the presence of free gas or fluid within the supra-and/or inframesocolic compartments, segmental bowel wall thickening, bowel wall discontinuity, stranding of the mesenteric fat and abscess formation. CONCLUSIONS These differentiating features facilitate accurate multidisciplinary pre-operative evaluation, necessary to plan patient management and potential surgical approach.

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“…Miki ve arkadaşları [30] kolon rüptürü olan 6 hastada yaptıkları çalışmada 6 hastadan 4'ünde duvar devamsızlığını göstermiştir. Imuta ve arkadaşlarının [10] çalışmasın-da 155 hastadan 44'ünde intravenöz kontrast madde kullanılmış ve bu 44 hastadan 14'ünde (%32) aksiyel imajlarda duvar devamsızlığı gösterilmiştir.…”

Section: Discussionunclassified

The Role of Abdominal CT in Determining Perforation Findings and Site in Patients with Gastrointestinal Tract Perforation.

Ilgar¹,

Elmalı²,

Nural³

2013

Ulus Travma Acil Cerrahi Derg

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AMAÇBu çalışmada gastrointestinal kanal perforasyonlu hastalarda karın bilgisayarlı tomografisinin (BT) perforasyon bulguları ve perforasyon yerini belirlemedeki rolü araştırıldı. GEREÇ VE YÖNTEMTemmuz 2007 ve Temmuz 2010 tarihleri arasında, gastrointestinal kanal perforasyonu olduğu cerrahi olarak kanıtlan-mış 47 hastanın ameliyat öncesi karın BT görüntüleri geriye dönük olarak değerlendirildi. Her bir hasta için BT'de serbest hava, kontrast madde kaçağı, duvar kalınlaşması, duvar devamsızlığı, apse, flegmon ve serbest sıvı varlığı araştırıldı. Belirlenen bu bulgular ışığında perforasyon yeri tahmin edildi ve cerrahi sonuçlar ile karşılaştırıldı. BULGULARKarın BT bulgularına göre gastroduodenal perforasyonu olan hastaların %85,7'sinde, ince bağırsak perforasyonu olanların %85,7'sinde, kalın bağırsak perforasyonu olanların %69,2'sinde, rektum perforasyonu olanların %100'ünde, apendiks perforasyonu olanların %90,9'unda, tüm hastaların ise %82,9'unda perforasyon yeri doğru olarak belirlendi. Gastrointestinal kanal perforasyonunda BT'de en sık rastlanan bulgu %89,4 oranı ile karında serbest sıvı idi. Diğer bulguların rastlanma oranları ise sı-rasıyla şöyleydi; serbest hava %76.6, segmental duvar kalınlaşması %48.9, duvar devamsızlığı %25.5, apse %12.8, flegmon %10,6. Oral kontrast kullanılan 30 hastanın 7'sinde (%23,3) ekstraluminal kontrast kaçağı saptandı. SONUÇBT gastrointestinal kanal perforasyon bulgularını ve perforasyon yerini belirlemede oldukça etkilidir.Anahtar Sözcükler: Bilgisayarlı tomografi; intestinal perforasyon; spiral bilgisayarlı tomografi.

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Multidetector-row CT findings of colonic perforation: direct visualization of ruptured colonic wall

Abstract: Abdominal contrast-enhanced MD-CT may improve the accuracy of diagnosis and localization of colonic perforation.

Cited by 40 publications

References 13 publications

64-slice multidetector computed tomography evaluation of gastrointestinal tract perforation site: detectability of direct findings in upper and lower GI tract

64-slice multidetector computed tomography evaluation of gastrointestinal tract perforation site: detectability of direct findings in upper and lower GI tract

Evolution of imaging for abdominal perforation

The Role of Abdominal CT in Determining Perforation Findings and Site in Patients with Gastrointestinal Tract Perforation.

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