Colorectal Perforation: Assessment with MDCT

Colorectal perforations are severe conditions with a high rate of mortality. CT plays an important role for diagnosis and identifies the etiology of acute abdomen. Nontraumatic colorectal perforation can be caused by inflammatory, neoplastic, or ischemic etiology as well as by iatrogenic injuries and as a postoperative complication. The diagnosis of GI tract perforation is based on direct CT findings, such as discontinuity of the bowel wall and the presence of extraluminal air, and on indirect CT findings represented by bowel wall thickening, abnormal bowel wall enhancement (includes interruption or lack of bowel wall enhancement on enhanced scan), abscess, and an inflammatory mass adjacent to the bowel.