Imaging recommendation · Abdomen · Pelvis

Acute abdomen with peritoneal signs, suspected perforation

Q: What's the alternative imaging for acute abdomen with peritoneal signs, suspected perforation when unstable patient at bedside?

XR — Upright CXR + Abdomen series (no contrast).

Q: What's the alternative imaging for acute abdomen with peritoneal signs, suspected perforation when suspected anastomotic leak?

CT — CT with water-soluble oral contrast (oral contrast).

Recommended: CT Abdomen / Pelvis with IV contrast is the preferred imaging study for acute abdomen with peritoneal signs, suspected perforation. Upright CXR + supine/upright abdomen films are a fast screen (free air = high specificity).

Recommended study

CT Abdomen / Pelvis with IV contrast

CT IV contrast Preferred Abdomen · Pelvis Emergency Reviewed 2026-05

Upright CXR + supine/upright abdomen films are a fast screen (free air = high specificity). CT localizes the site and the source.

If the default doesn't apply

Unstable patient at bedside

XR Upright CXR + Abdomen series No contrast

Suspected anastomotic leak

CT CT with water-soluble oral contrast Oral contrast