caa a22 4500 475842537 CHVBK 20180406123904.0 cr unu---uuuuu 170329e20001001xx s 000 0 eng 10.1007/PL00011837 doi (NATIONALLICENCE)springer-10.1007/PL00011837 Helical computed tomography diagnosis of gastrointestinal perforation in the elderly patient [Elektronische Daten] [A. Pinto, M. Scaglione, F. Pinto, L. Romano, R. Grassi, A. Rotondo] Purpose: To determine the value of helical CT in a consecutive series of elderly patients referred with clinically suspected gastrointestinal perforation. Methods: Our series comprised 34 consecutive elderly patients (mean age: 68 years) presenting with acute abdominal symptoms potentially suggestive of gastrointestinal perforation. All the patients were prospectively subjected to abdominal computed tomography (CT). On helical CT, the presence of free air was considered diagnostic of gastrointestinal perforation. Other findings such as intraperitoneal free fluid, thickening of bowel wall, streaky density within the mesentery, "dirty fat” sign, and focal collection of extraluminal fecal matter ("dirty mass”) were considered indirect findings of perforation. Results: At surgery, the following sites of perforation were found: duodenum (38.2 %), stomach (29.4 %), ileum (8.8 %), sigmoid colon (8.8 %), rectum (5.8 %), and jejunum, appendix, and transverse colon (2.9 % of cases each). CT demonstrated the presence of free air in 94.1 % of cases; intraperitoneal free fluid was present in 76.4 % of patients and thickening of bowel wall in 50 %. Streaky density within the mesentery was found in one patient. Conclusion: CT is a reliable diagnostic method by which to assess gastrointestinal perforation, because it provides excellent contrast resolution to depict the presence of even small amounts of free air in the abdomen. This is particularly helpful where elderly patients are concerned. American Society of Emergency Radiology, 2000 Key words Gastrointestinal tract, perforation - Pneumoperitoneum - Helical computed tomography nationallicence Pinto A. Department of Radiology, Cardarelli Hospital, Piazza Amedeo 15, I-80121 Naples, Italy Tel.: + 39-81-66 45 06 Fax: + 39-81-40 68 33, IT aut Scaglione M. Department of Radiology, Cardarelli Hospital, Piazza Amedeo 15, I-80121 Naples, Italy Tel.: + 39-81-66 45 06 Fax: + 39-81-40 68 33, IT aut Pinto F. Department of Radiology, Cardarelli Hospital, Piazza Amedeo 15, I-80121 Naples, Italy Tel.: + 39-81-66 45 06 Fax: + 39-81-40 68 33, IT aut Romano L. Department of Radiology, Cardarelli Hospital, Piazza Amedeo 15, I-80121 Naples, Italy Tel.: + 39-81-66 45 06 Fax: + 39-81-40 68 33, IT aut Grassi R. Department of Radiology, II University Hospital, Naples, Italy, IT aut Rotondo A. Department of Radiology, University Hospital, Bari, Italy, IT aut https://doi.org/10.1007/PL00011837 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/PL00011837 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Pinto A. Department of Radiology, Cardarelli Hospital, Piazza Amedeo 15, I-80121 Naples, Italy Tel.: + 39-81-66 45 06 Fax: + 39-81-40 68 33, IT aut NATIONALLICENCE 700 1- Scaglione M. Department of Radiology, Cardarelli Hospital, Piazza Amedeo 15, I-80121 Naples, Italy Tel.: + 39-81-66 45 06 Fax: + 39-81-40 68 33, IT aut NATIONALLICENCE 700 1- Pinto F. Department of Radiology, Cardarelli Hospital, Piazza Amedeo 15, I-80121 Naples, Italy Tel.: + 39-81-66 45 06 Fax: + 39-81-40 68 33, IT aut NATIONALLICENCE 700 1- Romano L. Department of Radiology, Cardarelli Hospital, Piazza Amedeo 15, I-80121 Naples, Italy Tel.: + 39-81-66 45 06 Fax: + 39-81-40 68 33, IT aut NATIONALLICENCE 700 1- Grassi R. Department of Radiology, II University Hospital, Naples, Italy, IT aut NATIONALLICENCE 700 1- Rotondo A. Department of Radiology, University Hospital, Bari, Italy, IT aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer