6. Evaluation of MSCT to determine gastrointestinal perforation site
Main Article Content
Abstract
We evaluated multiple computed tomographies (CT) imaging to determine the gastrointestinal tract perforation site. CT scans of 127 patients with aconfirmed diagnosis of gastrointestinal tract perforation by surgery, were evaluated at Vietnam - Germany Hospital from July 2021 to June 2022. On CT scan results, gastroduodenal perforation was common with subdiaphragmatic free air 90% with Se: 90%, NPV: 91.7%, OR = 9.2 (95%CI: 3.0 - 28.1, p < 0.01), ligamentum teres and falciform ligament in 67.5% with NPV: 81.4%, OR = 3.9 (95%CI: 1.8 - 8.7, p < 0.05), periportal free air in 42.5% with Sp: 85.1%, NPV: 76.3%, OR = 4.2, (95%CI: 1.8 - 9.9, p < 0.05), free air in supramesocolic 100% with Se: 100%, NPV: 100%) and difference with other perforation sites (p < 0.05). The amount of free air was higher in gastroduodenal perforation (mean 11.38mm, p < 0.05). Perforation of the sigmoid colon and rectum often have free air in minor pelvis 78.6% (with Se: 78.6%, Sp: 84.8%, NPV: 93.3%, Acc: 83.4%; p < 0.05) and mottled extraluminal air bubbles (Se: 92.9%, NPV: 94.4%, Acc: 47.3%). Therefore, CT scans are valuable to diagnose and locate gastrointestinal tract perforation site. Amount and location of pneumoperitoneum distribution in the abdomen are reliable markers for diagnosing gastrointestinal tract perforation site.
Article Details
Keywords
gastrointestinal tract perforation, computed tomography, gastrointestinal tract perforation site, pneumoperitoneum
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