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| ==Overview== | | ==Overview== |
| CT may be positive in unto 82%. CT may be indicated in all patients with acute abdomen. However, CT can be omitted when a diagnosis is made according to the results of precedent examinations such as US. Radiation exposure should be considered with the use of CT.
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| ==Key CT Findings in Secondary peritonitis==
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| *Contrast-enhanced CT is useful in identifying an intraabdominal source for infection.
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| * If the diagnosis of peritonitis is made clinically, a CT scan is not necessary and generally delays surgical intervention without offering clinical advantage.
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| * However, CT scanning is indicated in all cases in which the diagnosis cannot be established on clinical grounds and findings on abdominal plain films.
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| * CT scans of the abdomen and pelvis remain the diagnostic study of choice for peritoneal abscess and related visceral pathology.
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| * Whenever possible, the CT scan should be performed with enteral and intravenous contrast.
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| * CT scans can detect small quantities of fluid, areas of inflammation, and other GI tract pathology, with sensitivities that approach 100%. <ref name="BaderSchröder2009">{{cite journal|last1=Bader|first1=FG|last2=Schröder|first2=M|last3=Kujath|first3=P|last4=Muhl|first4=E|last5=Bruch|first5=H-P|last6=Eckmann|first6=C|title=Diffuse postoperative peritonitis -value of diagnostic parameters and impact of early indication for relaparotomy|journal=European Journal of Medical Research|volume=14|issue=11|year=2009|pages=491|issn=2047-783X|doi=10.1186/2047-783X-14-11-491}}</ref>
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| * CT scanning can be used to evaluate for ischemia, as well as to determine bowel obstruction.
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| * An abscess is suggested by the presence of fluid density that is not bound by the bowel or other known structures.
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| * Gas within an abdominal mass or the presence of an enhancing wall and adjacent inflammatory changes are also highly suggestive of an abscess.
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| * Ischemia can be demonstrated by a clot in a large vessel or by the absence of blood flow.
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| * Gas within the intestinal wall or in the [[portal vein]] may also suggest [[ischemia]].
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| * Enhanced CT is recommended for the evaluation of organ ischemia, vascular lesions, or acute [[Acute pancreatitis|pancreatitis]] severity.
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| * CT has high diagnosability for [[intestinal ischemia]], [[gastrointestinal perforation]], [[acute appendicitis]], [[diverticulitis]], biliary tract [[calculus]], and acute pancreatitis among others. However, these diseases cannot be completely ruled out, even if abnormalities are not found on CT.
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| * In patients taking a biguanide for diabetes, attention must be paid to the potential onset of lactic acidosis after iodinated contrast media administration .
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| * CT is also recommended for detecting intra-abdominal free air.
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| ==CT Examples of Secondary peritonitis==
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| ==References== | | ==References== |