ABSTRACT
BACKGROUND: We examined the findings of contrast-enhanced multidetector-row computed tomography (MD-CT) in patients with colonic perforation. METHODS: Abdominal contrast-enhanced MD-CT findings in six patients with colonic perforation were reviewed retrospectively. Patients (three men and three women) were 74 to 88 years old (mean age = 78 years). Colonic perforation was confirmed by surgery. CT findings were correlated with surgical and pathologic findings. RESULT: The site of colonic perforation was suggested by the following combination of CT findings: free air, dirty mass, dirty fat sign, extraluminal fluid collection, bowel wall thickening, and interruption of colonic wall. The ruptured colonic wall was directly visualized in four cases (67%). CONCLUSION: Abdominal contrast-enhanced MD-CT may improve the accuracy of diagnosis and localization of colonic perforation.
Subject(s)
Colonic Diseases/diagnostic imaging , Intestinal Perforation/diagnostic imaging , Tomography, X-Ray Computed/methods , Aged , Aged, 80 and over , Colonic Diseases/etiology , Female , Humans , Intestinal Perforation/etiology , Male , Radiographic Image Enhancement , Retrospective StudiesABSTRACT
This report concerns 2 cases with blunt traumatic hernia of the diaphragm. The diagnosis of these cases had been delayed by 1 month and 6 years, respectively. The former was a left sided case, which had suddenly suffered severe dyspnea. An emergency operation revealed the dislocated stomach into the left thoracic cavity. The latter was a right sided case, which was discovered by chance during the laparoscopic cholecystectomy. The right lobe of the liver dislocated into the right thoracic cavity. The delayed case of traumatic diaphragmatic hernia tends to be overlooked without suspicion. In all patients with thoracoabdominal blunt injury, a rupture of the diaphragm must be suspected.
