Atypical digestive tract perforation:Diagnosis of 90 cases

Objective To analyze the clinical features of atypical digestive tract perforation in order to increase its diagnostic rate. Methods Time,location and extent of abdominal pain,and its characteristics found at X-ray,CT and ultrasound examinations in 90 patients with digestive tract perforation diagnosed after operation were retrospectively analyzed and their clinical diagnostic value was evaluated. Results Of the 90 patients,35（38.89%） had typical acute abdominal pain,28（31.11%） had wooden belly.Typical signs were less in old patients than in young patients（P＜0.01）.Abdominal X-ray showed free air in sub-diaphragm of 70（73.33%） out of the 88 patients while CT revealed free air in sub-diaphragm of 8（83.33%） out of 11 patients（P＜0.05）.The success rate of diagnostic peritoneocentesis was 73.33%（11 out of 15 patients） with a positive rate of 72.72%（8 out of 11 patients）. Conclusion The clinical symptoms and signs of atypical digestive tract perforation are lack of specificity.Abdominal X-ray and CT in combination with diagnostic peritoneocentesis can improve its diagnostic rate.