CONVENTIONAL PLAIN-FILM RADIOLOGY, ULTRASONOGRAPHY AND CT IN JEJUNOILEAL PERFORATION

Purpose. To evaluate conventional radiography, US and CT in identifyin g jejuno-ileal perforation. Material and Methods: We retrospectively r eviewed the findings of conventional radiography, US and CT in 13 cons ecutive patients with surgically proven jejuno-ileal perforation. Resu lts: The site of perforation was the ileum in 10 cases and the jejunum in 3 cases. Free gas was identified in 6 cases (46%) while indirect f indings of perforation were found in 7 (54%). The jejunal perforations were diagnosed by indirect findings in all 3 cases. The ileal perfora tions were diagnosed by direct findings in 6 cases and indirect findin gs in 4 cases. Conclusion: Conventional radiology did not detect free gas in 7 (54%) of the 13 patients examined. In the absence of free gas , radiology showed indirect signs in all 7 patients, the most common b eing intraperitoneal free fluid in 5 (71%) of them. Jejunal perforatio ns were more rare than ileal perforations and more difficult to identi fy by radiology. US was not useful for detecting free gas but it was u seful for identifying intraperitoneal free fluid and intestinal paresi s. Abdominal CT was useful when performed 6 h after the symptoms began .