MDCT Findings in Gastrointestinal Perforations and the Predictive Value according to the Site of Perforation
<i>Background:</i> Gastrointestinal perforations are a frequent cause of acute abdominal symptomatology for patients in the emergency department. The aim of this study was to investigate the findings of multidetector-row computed tomography of gastrointestinal perforations and analyze th...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Tomography |
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| Online Access: | https://www.mdpi.com/2379-139X/8/2/56 |
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| author | Stefania Romano Carmela Somma Antonio Sciuto Warissara Jutidamrongphan Daniela Pacella Francesco Esposito Marta Puglia Claudio Mauriello Khanin Khanungwanitkul Felice Pirozzi |
| author_facet | Stefania Romano Carmela Somma Antonio Sciuto Warissara Jutidamrongphan Daniela Pacella Francesco Esposito Marta Puglia Claudio Mauriello Khanin Khanungwanitkul Felice Pirozzi |
| author_sort | Stefania Romano |
| collection | DOAJ |
| description | <i>Background:</i> Gastrointestinal perforations are a frequent cause of acute abdominal symptomatology for patients in the emergency department. The aim of this study was to investigate the findings of multidetector-row computed tomography of gastrointestinal perforations and analyze the impact of any imaging signs on the presurgical identification of the perforation site. <i>Methods:</i> We retrospectively reviewed emergency MDCT findings of 93 patients submitted to surgery for gastrointestinal perforation at two different institutions. Two radiologists separately reviewed the emergency MDCT examinations performed on each patient, before and after knowing the surgical diagnosis of the perforation site. A list of findings was considered. Positive predictive values were estimated for each finding with respect to each perforation site, and correspondence analysis (CA) was used to investigate the relationship between the findings and each of the perforation types. <i>Results:</i> We did not find inframesocolic free air in sigmoid colorectal perforations, and in rare cases, only supramesocolic free fluid in gastroduodenal perforations was found. A high PPV of perivisceral fat stranding due to colonic perforation and general distension of upstream loops and collapse of downstream loops were evident in most patients. <i>Conclusions:</i> Our data could offer additional information on the perforation site in the case of doubtful findings to support surgeons, especially in planning a laparoscopic approach. |
| first_indexed | 2024-03-09T10:28:41Z |
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| id | doaj.art-ecb373a55f5447c9bf37adc15d0b571c |
| institution | Directory Open Access Journal |
| issn | 2379-1381 2379-139X |
| language | English |
| last_indexed | 2024-03-09T10:28:41Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tomography |
| spelling | doaj.art-ecb373a55f5447c9bf37adc15d0b571c2023-12-01T21:29:10ZengMDPI AGTomography2379-13812379-139X2022-03-018266768710.3390/tomography8020056MDCT Findings in Gastrointestinal Perforations and the Predictive Value according to the Site of PerforationStefania Romano0Carmela Somma1Antonio Sciuto2Warissara Jutidamrongphan3Daniela Pacella4Francesco Esposito5Marta Puglia6Claudio Mauriello7Khanin Khanungwanitkul8Felice Pirozzi9Department of Radiology, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, ItalyDepartment of Neuroradiology, “Umberto I” Hospital, 80131 Nocera, ItalyDepartment of Surgery, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, ItalyDepartment of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, ThailandDepartment of Public Health, Federico II University of Naples, 80131 Naples, ItalyDepartment of Surgery, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, ItalyDepartment of Radiology, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, ItalyDepartment of Surgery, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, ItalyDepartment of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, ThailandDepartment of Surgery, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, Italy<i>Background:</i> Gastrointestinal perforations are a frequent cause of acute abdominal symptomatology for patients in the emergency department. The aim of this study was to investigate the findings of multidetector-row computed tomography of gastrointestinal perforations and analyze the impact of any imaging signs on the presurgical identification of the perforation site. <i>Methods:</i> We retrospectively reviewed emergency MDCT findings of 93 patients submitted to surgery for gastrointestinal perforation at two different institutions. Two radiologists separately reviewed the emergency MDCT examinations performed on each patient, before and after knowing the surgical diagnosis of the perforation site. A list of findings was considered. Positive predictive values were estimated for each finding with respect to each perforation site, and correspondence analysis (CA) was used to investigate the relationship between the findings and each of the perforation types. <i>Results:</i> We did not find inframesocolic free air in sigmoid colorectal perforations, and in rare cases, only supramesocolic free fluid in gastroduodenal perforations was found. A high PPV of perivisceral fat stranding due to colonic perforation and general distension of upstream loops and collapse of downstream loops were evident in most patients. <i>Conclusions:</i> Our data could offer additional information on the perforation site in the case of doubtful findings to support surgeons, especially in planning a laparoscopic approach.https://www.mdpi.com/2379-139X/8/2/56MDCTintestinal perforationspneumoperitoneumacute abdomensurgeryemergency |
| spellingShingle | Stefania Romano Carmela Somma Antonio Sciuto Warissara Jutidamrongphan Daniela Pacella Francesco Esposito Marta Puglia Claudio Mauriello Khanin Khanungwanitkul Felice Pirozzi MDCT Findings in Gastrointestinal Perforations and the Predictive Value according to the Site of Perforation Tomography MDCT intestinal perforations pneumoperitoneum acute abdomen surgery emergency |
| title | MDCT Findings in Gastrointestinal Perforations and the Predictive Value according to the Site of Perforation |
| title_full | MDCT Findings in Gastrointestinal Perforations and the Predictive Value according to the Site of Perforation |
| title_fullStr | MDCT Findings in Gastrointestinal Perforations and the Predictive Value according to the Site of Perforation |
| title_full_unstemmed | MDCT Findings in Gastrointestinal Perforations and the Predictive Value according to the Site of Perforation |
| title_short | MDCT Findings in Gastrointestinal Perforations and the Predictive Value according to the Site of Perforation |
| title_sort | mdct findings in gastrointestinal perforations and the predictive value according to the site of perforation |
| topic | MDCT intestinal perforations pneumoperitoneum acute abdomen surgery emergency |
| url | https://www.mdpi.com/2379-139X/8/2/56 |
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