Peritonitis CT
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Peritonitis Main Page |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]
Overview
CT
- Contrast-enhanced CT is useful in identifying an intraabdominal source for infection.
- If the diagnosis of peritonitis is made clinically, a CT scan is not necessary and generally delays surgical intervention without offering clinical advantage.
- However, CT scanning is indicated in all cases in which the diagnosis cannot be established on clinical grounds and findings on abdominal plain films.
- CT scans of the abdomen and pelvis remain the diagnostic study of choice for peritoneal abscess and related visceral pathology.
- Whenever possible, the CT scan should be performed with enteral and intravenous contrast.
- CT scans can detect small quantities of fluid, areas of inflammation, and other GI tract pathology, with sensitivities that approach 100%.
- CT scanning can be used to evaluate for ischemia, as well as to determine bowel obstruction.
- An abscess is suggested by the presence of fluid density that is not bound by the bowel or other known structures.
- Gas within an abdominal mass or the presence of an enhancing wall and adjacent inflammatory changes are also highly suggestive of an abscess.
- Ischemia can be demonstrated by a clot in a large vessel or by the absence of blood flow.
- Gas within the intestinal wall or in the portal vein may also suggest ischemia.