Abdominal Imaging

, Volume 39, Issue 4, pp 802–823 | Cite as

From esophagus to rectum: a comprehensive review of alimentary tract perforations at computed tomography

  • Andrew J. Del Gaizo
  • Chandana Lall
  • Brian C. Allen
  • John R. Leyendecker
Review Paper


Gastrointestinal (GI) tract perforation is a life-threatening condition that can occur at any site along the alimentary tract. Early perforation detection and intervention significantly improves patient outcome. With a high sensitivity for pneumoperitoneum, computed tomography (CT) is widely accepted as the diagnostic modality of choice when a perforated hollow viscus is suspected. While confirming the presence of a perforation is critical, clinical management and surgical technique also depend on localizing the perforation site. CT is accurate in detecting the site of perforation, with segmental bowel wall thickening, focal bowel wall defect, or bubbles of extraluminal gas concentrated in close proximity to the bowel wall shown to be the most specific findings. In this article, we will present the causes for perforation at each site throughout the GI tract and review the patterns that can lead to prospective diagnosis and perforation site localization utilizing CT images of surgically proven cases.


Gastrointestinal Perforation Computed tomography 


Conflict of interest



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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Andrew J. Del Gaizo
    • 1
  • Chandana Lall
    • 2
  • Brian C. Allen
    • 1
  • John R. Leyendecker
    • 1
  1. 1.Department of RadiologyWake Forest University Baptist Medical CenterWinston-SalemUSA
  2. 2.Department of RadiologyUniversity of California Irvine Medical CenterOrangeUSA

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