Abstract
Peritonitis caused by an infection by the resident flora of the gastrointestinal tract resulting from a break of the integrity of the intestinal tract is a secondary peritonitis.
The type and degree of peritoneal contamination depends on the site of perforation.
CT direct signs of gastrointestinal perforation are extraluminal air with gas bubbles in close proximity to the discontinuity in the gastrointestinal wall, focal wall defect, and leakage of luminal contrast when administrated.
CT signs of peritonitis due to gastrointestinal perforation more frequently depicted are increased fat density adjacent to the site of wall defect, perigastrointestinal fluid, stranding, and gas bubbles in close proximity to the site of perforation.
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References
Ordonez CA, Puyana JC (2006) Management of peritonitis in the critically ill patient. Surg Clin North Am 86:1323–1349
Pinto A, Romano L (2013) Peritonitis. In: Guglielmi G et al (eds) Geriatric imaging. Springer, Berlin/Heidelberg, pp 741–751
Wittman DH, Schein M, Condon RE (1996) Management of secondary peritonitis. Ann Surg 224(1):10–18
Guarner F (2006) Enteric flora in health and disease. Digestion 73(Suppl 1):5–12
Guarner F, Malageleda JR (2003) Gut flora in health and disease. Lancet 361:512–519
Goh BK, Chow PK, Quah HM et al (2006) Penetration of the gastrointestinal tract secondary to ingestion of foreign bodies. World J Surg 30(3):372–377
Ozel H, Topaloglu S, Yuksel BC et al (2003) Jejunal perforation in mentally retarded patient due to an ingested chicken bone. Hepatogastroenterology 50(Suppl 2):ccxxxviii–ccxxxix
Kimchi NA, Brodie E, Shapiro M et al (2002) Non-traumatic perforation of the small intestine: report of 13 cases and review of the literature. Hepatogastroenterology 49(46):1017–1022
Moran BJ (2007) Adhesion-related small bowel obstruction. Colorectal Dis 9(Suppl 2):39–44
Kashakura Y, Ajani JA, Fugii M et al (2002) Management of perforated gastric carcinoma: a report of 16 cases and review of world literature. Am Surg 68:434–440
Hayetian FD, Read TE, Brozovich M et al (2006) Ileal perforation secondary to Clostridium difficile enteritis. Arch Surg 141:97–99
Maniatis V, Chryssikopoulos H, Roussakis A et al (2000) Perforation of the alimentary tract: evaluation with computed tomography. Abdom Imaging 25:373–379
Haianaux B, Agneessens E, Bertinotti R et al (2006) Accuracy of MDCT in predicting site of gastrointestinal tract perforation. AJR Am J Roentgenol 187(5):1179–1183
Kim SH, Shin SS, Jeong YY et al (2009) Gastrointestinal tract perforation: MDCT findings according to the perforation sites. Korean J Radiol 10(1):63–70
Chen CH, Huang HS, Yang CC et al (2001) The features of perforated peptic ulcers In conventional computed tomography. Hepatogastroenterology 48:1393–1396
Shaffer HA (1992) Perforation and obstruction of the gastrointestinal tract. Assessment by conventional radiology. Radiol Clin North Am 30:405–426
Meyers MA (2000) The extraperitoneal space: normal and pathologic anatomy. In: Meyers MA (ed) Dynamic Radiology of the abdomen. Springer, New York, pp 333–492
Glazer GM, Buy JN, Moss AA et al (1981) Ct detection of duodenal perforation. AJR Am J Roentgenol 137:333–336
Kim SW, Kim HC, Yang DM (2012) Perforated tumours in the gastrointestinal tract: CT findings and clinical presentation. Br J Radiol 85:1307–1313
Enns R, Eloubeidi MA, Mergener K et al (2002) ERCP-related perforation: risk factors and management. Endoscopy 34(4):293–298
Ghahremani GG, Ghahremani GG (1993) Radiologic evaluation of suspected gastrointestinal perforations. Radiol Clin North Am 31:1219–1234
Greenstein AJ, Mann D, Sachar DB et al (1985) Free perforation in Crohn’s disease: I. A survey of 99 cases. Am J Gastroenterol 80(9):682–689
Zissin R, Osadchy A, Gayer G (2009) Abdominal CT findings in small bowel perforation. Br J Radiol 82(974):162–171
Horrow MM, White DS, Horrow JC (2003) Differentiation of perforated from non perforated appendicitis at CT. Radiology 227:46–51
Saeki M, Hoshikawa Y, Miyazaki O et al (1998) Computed tomographic analysis of colonic perforation: “dirty mass” a new computed tomographic finding. Emerg Radiol 5:140–145
Thomas PR (1987) Ano-rectal injury causing extraperitoneal and subcutaneous emphysema. Injury 18:426–427
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Miele, V., Sessa, B. (2015). Role of Multidetector Row Computed Tomography in the Diagnosis of Acute Peritonitis Due to Gastrointestinal Perforation. In: Romano, L., Pinto, A. (eds) Imaging of Alimentary Tract Perforation. Springer, Cham. https://doi.org/10.1007/978-3-319-08192-2_16
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DOI: https://doi.org/10.1007/978-3-319-08192-2_16
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