Correlation of gastrointestinal perforation location and amount of free air and ascites on CT imaging.

Drakopoulos, Dionysios; Arcon, Jacqueline; Freitag, Peter; El-Ashmawy, Mostafa; Lourens, Steven; Beldi, Guido; Obmann, Verena Carola; Ebner, Lukas; Huber, Adrian Thomas; Christe, Andreas (2021). Correlation of gastrointestinal perforation location and amount of free air and ascites on CT imaging. Abdominal radiology, 46(10), pp. 4536-4547. Springer 10.1007/s00261-021-03128-2

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PURPOSE

To analyze the amount of free abdominal gas and ascites on computed tomography (CT) images relative to the location of a perforation.

METHODS

We retrospectively included 172 consecutive patients (93:79 = m:f) with GIT perforation, who underwent abdominal surgery (ground truth for perforation location). The volume of free air and ascites were quantified on CT images by 4 radiologists and a semiautomated software. The relation of the perforation location (upper/lower GIT) and amount of free air and ascites was analyzed by the Mann-Whitney test. Furthermore, best volume cutoff for upper and lower GIT perforation, areas under the curve (AUC), and interreader volume agreement were assessed.

RESULTS

There was significantly more abdominal ascites with upper GIT perforation (333 ml, range 5 to 2000 ml) than with lower GIT perforation (100 ml, range 5 to 2000 ml, p = 0.022). The highest volume of free air was found with perforations of the stomach, descending colon and sigmoid colon. Significantly less free air was found with perforations of the small bowel and ascending colon compared to the aforementioned. An ascites volume > 333 ml was associated with an upper GIT perforation demonstrating an AUC of 0.63 ± 0.04.

CONCLUSION

Using a two-step process based on the volumes of free air and free fluid can help localizing the site of perforation to the upper, middle or lower GI tract.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery

UniBE Contributor:

Drakopoulos, Dionysios; Freitag, Peter; Beldi, Guido; Obmann, Verena Carola; Ebner, Lukas; Huber, Adrian Thomas and Christe, Andreas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2366-0058

Publisher:

Springer

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

22 Jun 2021 12:16

Last Modified:

15 Sep 2021 01:32

Publisher DOI:

10.1007/s00261-021-03128-2

PubMed ID:

34114087

Uncontrolled Keywords:

Abdominal CT imaging CT volumetry Gastrointestinal perforation Volumetry of air Volumetry of ascites

BORIS DOI:

10.48350/156872

URI:

https://boris.unibe.ch/id/eprint/156872

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