Trends in and Value and Consequences of Radiologic Imaging of Perforated Gastroduodenal Ulcer

Abstract

The trends in and value and consequences of radiologic imaging in 1128 patients with perforated gastroduodenal ulcer have been studied over the 50-year period 1935-1985. The proportion of patients undergoing plain X-ray studies increased from 4% in the first 5-year period (1935-1939) to 94% in the last (1980-1985). Pneumoperitoneum was found in 77% of those undergoing X-ray studies. Water-soluble contrast studies were introduced in 1960, and in the three 5-year periods 1970-1985 from 8% to 13% underwent such imaging. Leakage was demonstrated in 60% of those undergoing contrast studies. Contrast studies have had a limited role in the pretreatment evaluation of these patients. The frequency of pneumoperitoneum was fairly constant over the 50-year period, and the only patient characteristic that influenced the occurrence of free gas in the abdominal cavity was age, with a higher proportion of patients with pneumoperitoneum in old patients. Any radiologic study increased treatment delay by at least 2 h.