Gastrointestinal Imaging

Perforation, gastrointestinal

perforation of the gastrointestinal wall occurring anywhere from the pharynx to the rectum. The cause may be trauma, i.e. road traffic accident or iatrogenic. Perforations arising as complications of peptic ulcer disease or neoplasms are also frequent. Symptoms are usually alarming but may be insidious especially in the elderly.

Diagnosis relies mainly on plain film of the abdomen, cross-sectional imaging for demonstration of extraluminal air (pneumoperitoneum) and local thickening of the bowel wall. Perforation may also be demonstrated by iodine contrast examination which should be obtained either perorally or via gastroduodenal catheter, followed by fluoroscopy or cross-sectional imaging.

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