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Gastrointestinal perforation is defined by a full-thickness injury to all layers of the gastrointestinal wall, resulting in a hole in the hollow GI tract (esophagus, stomach, small intestine, or large intestine). A hole can occur due to direct mechanical injury or progressive damage to the bowel wall due to various disease states.
Pneumoperitoneum is pneumatosis (abnormal presence of air or other gas) in the peritoneal cavity, a potential space within the abdominal cavity.The most common cause is a perforated abdominal organ, generally from a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma.
Organ perforation is a complete penetration of the wall of a hollow organ in the body, such as the gastrointestinal tract in the case of gastrointestinal perforation. It mainly refers to accidental or pathologic perforation, rather than intentional penetration during surgery. It can lead to peritonitis if untreated. [2]
In suspected intussusception, an abdominal x-ray does not exclude intussusception but is useful in the differential diagnosis to exclude perforation or obstruction. [ 1 ] Yet, CT scan is the best alternative for diagnosing intra-abdominal injury.
Intestinal perforation is a risk of any gastroenterologic endoscopic procedure, and is an additional risk if a sphincterotomy is performed. As the second part of the duodenum is anatomically in a retroperitoneal location (that is, behind the peritoneal structures of the abdomen), perforations due to sphincterotomies are retroperitoneal.
The main risks are infection, over-sedation, perforation, or a tear of the stomach or esophagus lining and bleeding. [10] Although perforation generally requires surgery, certain cases may be treated with antibiotics and intravenous fluids. Bleeding may occur at the site of a biopsy or polyp removal.
Diaphragm, e.g. evidence of free air, indicative of perforation of an abdominal viscus; Edges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaques; Extrathoracic tissues; Fields (lung parenchyma), being evidence of alveolar flooding; Failure, e.g. alveolar air space disease with prominent vascularity with or without pleural ...
In cases of suspected bowel leak or perforation, gastrointestinal fistula, interloop abscess or other fluid collection, oncologic staging and surveillance, and CT colonography, oral positive contrast is useful in delineating the lesions. [3] 1% dilute barium solution can be administered orally for bowel preparation for CT scan of the abdomen. [4]