Gastrointestinal perforation causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

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Overview

Gastrointestinal perforation causes

Causes of gastrointestinal perforation in adults

Instrumentation
  • Instrumentation of the gastrointestinal tract includes upper endoscopy, sigmoidoscopy, colonoscopy, stent placement, endoscopic sclerotherapy, nasogastric intubation, esophageal dilation, and surgery.[1]
  • The area of the esophagus at most risk for instrumental perforation is Killian's triangle, which is the part of the pharynx formed by the inferior pharyngeal constrictor and cricopharyngeus muscle.
  • Gastrointestinal leakage can also occur postoperatively as a result of anastomotic breakdown.[2]
  • Immunosuppressed individuals may be at increased risk for dehiscence and deep organ space infection following surgery.[3]
Other causes
  • Violent retching can lead to spontaneous esophageal perforation, known as Boerhaave syndrome due to increased intraesophageal pressure in the lower esophagus.
Small intestine causes
Large intestine causes
  • Colonic diverticulosis is common in the developed world. They can become inflamed and perforate and may lead to abscess formation.

Causes of spontaneous intestinal perforation in adults[10]

Causes of intestinal perforation in neonates

References

  1. Akbulut S, Cakabay B, Ozmen CA, Sezgin A, Sevinc MM (2009). "An unusual cause of ileal perforation: report of a case and literature review". World J Gastroenterol. 15 (21): 2672–4. PMC 2691502. PMID 19496201.
  2. Rickles AS, Iannuzzi JC, Kelly KN, Cooney RN, Brown DA, Davidson M; et al. (2013). "Anastomotic leak or organ space surgical site infection: What are we missing in our quality improvement programs?". Surgery. 154 (4): 680–7, discussion 687-9. doi:10.1016/j.surg.2013.06.035. PMID 24074406.
  3. Ismael H, Horst M, Farooq M, Jordon J, Patton JH, Rubinfeld IS (2011). "Adverse effects of preoperative steroid use on surgical outcomes". Am J Surg. 201 (3): 305–8, discussion 308-9. doi:10.1016/j.amjsurg.2010.09.018. PMID 21367368.
  4. Morris CR, Harvey IM, Stebbings WS, Speakman CT, Kennedy HJ, Hart AR (2003). "Anti-inflammatory drugs, analgesics and the risk of perforated colonic diverticular disease". Br J Surg. 90 (10): 1267–72. doi:10.1002/bjs.4221. PMID 14515298.
  5. Strangfeld A, Richter A, Siegmund B, Herzer P, Rockwitz K, Demary W; et al. (2017). "Risk for lower intestinal perforations in patients with rheumatoid arthritis treated with tocilizumab in comparison to treatment with other biologic or conventional synthetic DMARDs". Ann Rheum Dis. 76 (3): 504–510. doi:10.1136/annrheumdis-2016-209773. PMC 5445993. PMID 27405509.
  6. Wu JT, Mattox KL, Wall MJ (2007). "Esophageal perforations: new perspectives and treatment paradigms". J Trauma. 63 (5): 1173–84. doi:10.1097/TA.0b013e31805c0dd4. PMID 17993968.
  7. Werbin N, Haddad R, Greenberg R, Karin E, Skornick Y (2003). "Free perforation in Crohn's disease". Isr Med Assoc J. 5 (3): 175–7. PMID 12725136.
  8. Singh NG, Mannan AA, Kahvic M, Alanzi FM (2010). "Jejunal perforation caused by schistosomiasis". Trop Doct. 40 (3): 191–2. doi:10.1258/td.2010.090352. PMID 20555055.
  9. Ara C, Coban S, Kayaalp C, Yilmaz S, Kirimlioglu V (2007). "Spontaneous intestinal perforation due to non-Hodgkin's lymphoma: evaluation of eight cases". Dig Dis Sci. 52 (8): 1752–6. doi:10.1007/s10620-006-9279-x. PMID 17420936.
  10. Gordon PV, Young ML, Marshall DD (2001). "Focal small bowel perforation: an adverse effect of early postnatal dexamethasone therapy in extremely low birth weight infants". J Perinatol. 21 (3): 156–60. doi:10.1038/sj.jp.7200520. PMID 11503101.
  11. Stavel M, Wong J, Cieslak Z, Sherlock R, Claveau M, Shah PS (2017). "Effect of prophylactic indomethacin administration and early feeding on spontaneous intestinal perforation in extremely low-birth-weight infants". J Perinatol. 37 (2): 188–193. doi:10.1038/jp.2016.196. PMID 27763630.