Diagnostic approach to alimentary tract perforations

Abstract

Alimentary tract perforations represent an emergency and life-threatening condition requiring prompt diagnosis and surgical treatment. The clinical diagnosis, particularly in the early stage, is difficult as the symptoms may be variable and nonspecific. The imaging plays an important role to determine the diagnosis and ensure an appropriate treatment to these patients. In this chapter, the diagnostic approach to alimentary tract perforations is discussed focusing on each of the following imaging methods: plain abdominal X-ray, ultrasound (US), computed tomography (CT), and magnetic resonance (MR). Plain abdominal X-ray still remains the most frequently requested imaging examination in the emergency department; the US and CT traditionally have been the dominant cross-sectional imaging modalities for evaluating acute thoracic, abdominal, and pelvic conditions; MR can be useful in the differential diagnosis of acute abdomen in specific patients.