caa a22 4500 60617155X CHVBK 20210128100723.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10140-014-1283-4 doi (NATIONALLICENCE)springer-10.1007/s10140-014-1283-4 The emergency room diagnosis of gastrointestinal tract perforation: the role of CT [Elektronische Daten] [Samuel Borofsky, Myles Taffel, Nadia Khati, Robert Zeman, Michael Hill] Computed tomography (CT) plays an important role in the evaluation of patients presenting to the emergency department with a suspected spontaneous gastrointestinal tract (GIT) perforation. Prospective identification of the site of perforation helps the emergency department physician plan the appropriate treatment in a potentially unstable patient. The purpose of this pictorial essay is to review the CT approach a radiologist should take when evaluating the patient with suspected perforation in the emergent setting. A series of patients presenting to the emergency department with surgically proven GIT perforations were retrospectively reviewed, and key images were obtained. For the purposes of this review, the anatomy of the abdominal cavity in relation to sites of GIT perforation will be discussed. CT findings of perforation will be described, including free intraperitoneal/extraperitoneal air, bowel wall discontinuity, and localized inflammatory changes. The use of a bone window setting to increase the free air conspicuity will be emphasized. The mimics of pneumoperitoneum will be demonstrated, including pneumothorax, pneumomediastinum, and venous air. Using a systematic approach, CT can precisely determine the presence and site of a gastrointestinal perforation in a majority of patients. This greatly assists the surgeon in planning the correct surgical approach. American Society of Emergency Radiology, 2014 Gastrointestinal tract nationallicence Perforation nationallicence Free air nationallicence Pneumoperitoneum nationallicence Borofsky Samuel Department of Radiology, The George Washington University Hospital, 900 23rd Street NW, 20037, Washington, DC, USA aut Taffel Myles Department of Radiology, The George Washington University Hospital, 900 23rd Street NW, 20037, Washington, DC, USA aut Khati Nadia Department of Radiology, The George Washington University Hospital, 900 23rd Street NW, 20037, Washington, DC, USA aut Zeman Robert Department of Radiology, The George Washington University Hospital, 900 23rd Street NW, 20037, Washington, DC, USA aut Hill Michael Department of Radiology, The George Washington University Hospital, 900 23rd Street NW, 20037, Washington, DC, USA aut Emergency Radiology Springer Berlin Heidelberg 22/3(2015-06-01), 315-327 1070-3004 22:3<315 2015 22 10140 https://doi.org/10.1007/s10140-014-1283-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10140-014-1283-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Borofsky Samuel Department of Radiology, The George Washington University Hospital, 900 23rd Street NW, 20037, Washington, DC, USA aut NATIONALLICENCE 700 1- Taffel Myles Department of Radiology, The George Washington University Hospital, 900 23rd Street NW, 20037, Washington, DC, USA aut NATIONALLICENCE 700 1- Khati Nadia Department of Radiology, The George Washington University Hospital, 900 23rd Street NW, 20037, Washington, DC, USA aut NATIONALLICENCE 700 1- Zeman Robert Department of Radiology, The George Washington University Hospital, 900 23rd Street NW, 20037, Washington, DC, USA aut NATIONALLICENCE 700 1- Hill Michael Department of Radiology, The George Washington University Hospital, 900 23rd Street NW, 20037, Washington, DC, USA aut NATIONALLICENCE 773 0- Emergency Radiology Springer Berlin Heidelberg 22/3(2015-06-01), 315-327 1070-3004 22:3<315 2015 22 10140