EURORAD ESR

Case 14970

Pneumoperitoneum due to colonic rupture

Author(s)
Anuradha Rao1, Divyalakshmi2, Raghuram P3

1. Assistant Professor
2. Senior resident
3. Professor
Department of Radiology,
Kidwai memorial institue of Oncology,
Bangalore, India
 
Patient
female, 58 year(s)
 
 
  • Figure 1
    Axial contrast-enhanced CT abdomen

    Axial CECT image of the abdomen showing a large air fluid level (arrow) due to pneumoperitoneum.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Imaging sequences; Special Focus: Acute;
     
     
  • Figure 2
    Axial CT abdomen (lung window)

    Air pockets also noted in the subcutaneous region in the midline at the site of incision (arrow). Image in lung window better delineates free air in the abdomen.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Treatment effects; Special Focus: Acute;
     
     
  • Figure 3
    Axial contrast-enhanced CT abdomen

    Axial CECT image shows defect in the colonic wall with thickening and heterogenous enhancement at site of perforation.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Colonography CT; Special Focus: Acute;
     
     
  • Figure 4
    Axial contrast-enhanced CT abdomen

    Axial CECT image is showing significant thinning (arrow) of the colonic wall adjacent to defect with impending rupture.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Colonography CT; Special Focus: Acute;
     
     
  • Figure 5
    Axial contrast-enhanced CT lower thorax

    Axial section in the lower thorax is showing bilateral pleural effusion and basal atelectatic changes. Also note ahypodense enhancing lesion in liver suggestive of metastasis (arrow).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Colonography CT; Special Focus: Acute;
     
     
  • Figure 6
    Coronal contrast-enhanced CT abdomen

    Coronal reformatted image of the abdomen showing colonic defect (arrow) with large ascites.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Colonography CT; Special Focus: Acute;
     
     
Axial CECT image of the abdomen showing a large air fluid level (arrow) due to pneumoperitoneum.
 
Air pockets also noted in the subcutaneous region in the midline at the site of incision (arrow). Image in lung window better delineates free air in the abdomen.
 
Axial CECT image shows defect in the colonic wall with thickening and heterogenous enhancement at site of perforation.
 
Axial CECT image is showing significant thinning (arrow) of the colonic wall adjacent to defect with impending rupture.
 
Axial section in the lower thorax is showing bilateral pleural effusion and basal atelectatic changes. Also note ahypodense enhancing lesion in liver suggestive of metastasis (arrow).
 
Coronal reformatted image of the abdomen showing colonic defect (arrow) with large ascites.
 
 
 
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