colonic perforation

Gastrointestinal

perforation: clinical and MDCT clues for identification of aetiology. 62-year-old patient with colonic rupture into the abdominal wall. a Coronal and (b) axial contrast-enhanced images illustrate a soft tissue mass (*) arising from the descending colon (arrow), extending into an abscess (ab) containing air-fluid level. Note the extraperitoneal gas bubbles (arrowheads) abutting the muscular fascias

Gastrointestinal

perforation: clinical and MDCT clues for identification of aetiology. 82-year-old oncology patient presenting with spontaneous perforation of the ascending colon. Coronal oblique contrast-enhanced image (modified soft tissue window) depicts pneumatosis intestinalis (arrow) and free gas extending to the right pararenal space and to the bare area of the liver (arrowheads) consistent with retropneumoperitoneum. A left retroperitoneal haemorrhage is noted as an independent finding (*)

Gastrointestinal

perforation: clinical and MDCT clues for identification of aetiology. 87-year-old patient with stercoral colitis and imminent stercoral perforation. Axial contrast-enhanced image shows a giant faecaloma (*), compressing a thickened rectal wall (between arrows), associated with perirectal fat stranding (arrowheads)