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GI Radiography |
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| ________SCROLL
FOR ANSWER__________ Imaging
Findings Study
shows thickened duodenal wall (D1 segment) along with presence of air
along its postero-medial wall (site of perforation). Diagnosis: Perforated duodenal ulcer Discussion:
CT plays no significant role in
the initial diagnosis of peptic ulcer disease; however, it is very
important in the diagnosis and treatment of complications. Perforation of
a peptic ulcer usually results in pneumoperitoneum which is significant
enough to be identified on upright or left lateral decubitus plain
radiographs of the abdomen. However, sometimes only a very small amount of
free intraperitoneal air is present and can only be identified on CT. The
finding of extravasated water soluble oral contrast is a rare finding. Ulcers on the anterior wall of
the stomach or duodenum directly abut the peritoneal cavity; therefore,
perforation of penetrating ulcers of the anterior wall may result in acute
peritonitis with spillage of gastric and duodenal contents. The volume of
gas that escapes into the peritoneal cavity depends on how quickly the
site of perforation becomes sealed off. Links
and References Balsara VJ, Haaga JR. The
Gastrointestinal Tract. In: Computed Tomography
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