gastrointestinal disorders
Acute Perforation of the Gastrointestinal Tract
Diagnosis of Acute Perforation of the GI Tract
Abdominal series If nondiagnostic, abdominal CT An abdominal series (supine and upright abdominal x-rays and chest x-rays) may be diagnostic, showing free air under the diaphragm in 50 to 75% of cases. As time passes, this sign becomes more common. A lateral chest x-ray is more sensitive for free air than a posteroanterior x-ray. If the abdominal series is nondiagnostic, abdominal CT usually with oral and IV and/or rectal contrast may be helpful. Barium should not be used if perforation is suspected. 