Bowel Dilatation On Computed Tomography: Diagnosis Of Lower Gastrointestinal Tract Perforations

Objective: To evaluate bowel dilation as an indirect finding predictive of lower gastrointestinal tract (GI) perforation using multidetector computed tomography (MDCT). Methods: This study retrospectively enrolled 93 consecutive patients presenting with exhibiting extraluminal air (EA) on MDCT. Two reviewers independently evaluated the degree of dilation of each segment and the dilation region in each patient. Results: The incidence of obstructive bowel dilation was 0% in upper GI tract perforation cases and 82.61% in lower GI tract perforation cases, respectively. Significant differences (P<0.05) was observed in the dilation degree between the lower and upper GI tract perforations. The sensitivity of bowel dilation for the detection of lower GI tract perforations was 82.61%, higher than that of the upper GI tract perforation (0%). Significant difference in sensitivity (P<.001) was observed. And multiple causes lead to intestinal perforation accompanied by obstructive bowel dilation. Conclusions: Obstructive bowel dilation could be an indirect CT finding to identify the upper and lower GI tract perforations with high sensitivity.