Gastrointestinal perforation classification

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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 classification

Gastrointestinal perforation can be classified by causes into:

Instrumental:
  • Instrumentation of the gastrointestinal tract includes upper endoscopy, sigmoidoscopy, colonoscopy, stent placement, endoscopic sclerotherapy, nasogastric intubation, esophageal dilation, and surgery.
  • 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.
  • Immunosuppressed individuals may be at increased risk for dehiscence and deep organ space infection following surgery.
Iatrogenic:
Inflammatory
  • Crohn's disease has a propensity to perforate slowly, leading to formation of entero-enteric or enterocutaneous fistula formation.
Medication
Neoplasm
  • Neoplasms can perforate by direct penetration and necrosis, or by producing obstruction.

Gastrointestinal perforation can be classified by age into:

References