{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:04:35Z","timestamp":1790946275280,"version":"4.1.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100009068","name":"Universit\u00e4t Bern","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009068","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Abdom Radiol"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To analyze the amount of free abdominal gas and ascites on computed tomography (CT) images relative to the location of a perforation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively included 172 consecutive patients (93:79\u2009=\u2009m:f) with GIT perforation, who underwent abdominal surgery (ground truth for perforation location). The volume of free air and ascites were quantified on CT images by 4 radiologists and a semiautomated software. The relation of the perforation location (upper\/lower GIT) and amount of free air and ascites was analyzed by the Mann\u2013Whitney test. Furthermore, best volume cutoff for upper and lower GIT perforation, areas under the curve (AUC), and interreader volume agreement were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was significantly more abdominal ascites with upper GIT perforation (333\u00a0ml, range 5 to 2000\u00a0ml) than with lower GIT perforation (100\u00a0ml, range 5 to 2000\u00a0ml,<jats:italic>p<\/jats:italic>\u2009=\u20090.022). The highest volume of free air was found with perforations of the stomach, descending colon and sigmoid colon. Significantly less free air was found with perforations of the small bowel and ascending colon compared to the aforementioned. An ascites volume\u2009&gt;\u2009333\u00a0ml was associated with an upper GIT perforation demonstrating an AUC of 0.63\u2009\u00b1\u20090.04.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Using a two-step process based on the volumes of free air and free fluid can help localizing the site of perforation to the upper, middle or lower GI tract.<\/jats:p><\/jats:sec><jats:sec><jats:title>Graphic abstract<\/jats:title><\/jats:sec>","DOI":"10.1007\/s00261-021-03128-2","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T18:02:48Z","timestamp":1623348168000},"page":"4536-4547","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Correlation of gastrointestinal perforation location and amount of free air and ascites on CT imaging"],"prefix":"10.1007","volume":"46","author":[{"given":"Dionysios","family":"Drakopoulos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Arcon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Freitag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"El-Ashmawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Lourens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Beldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6572-9968","authenticated-orcid":false,"given":"Verena Carola","family":"Obmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5117-6047","authenticated-orcid":false,"given":"Lukas","family":"Ebner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6146-8238","authenticated-orcid":false,"given":"Adrian Thomas","family":"Huber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2355-2591","authenticated-orcid":false,"given":"Andreas","family":"Christe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,10]]},"reference":[{"key":"3128_CR1","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/S0033-8389(22)00317-7","volume":"31","author":"GG Ghahremani","year":"1993","unstructured":"Ghahremani GG (1993) Radiologic evaluation of suspected gastrointestinal perforations. 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