Gastrointestinal perforation epidemiology and demographics
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
Esophageal perforation[1]
- The incidence of iatrogenic esophageal perforation from instrumentation has decreased, but the number of esophageal perforations from external trauma and spontaneous rupture has increased.
- In the period from 1950 to 1954 there was 1 perforation per 20,000 admissions.
- The incidence has now risen to 1 per 8,000 admissions.
Peptic perforation[2]
- There is lower incidence of peptic ulcer complications during the later years.
- Incidence rates varied from 1.5 to 7.8/100000 per year regarding perforated peptic ulcers and from 5.2 to 40.2 regarding peptic ulcer bleeding.
- A perforation rate of 0.11 percent for rigid endoscopy contrasts with a 0.03 percent rate for flexible endoscopy.
- Diagnostic endoscopy with a flexible endoscope perforation rate is 0.03 percent.
- Diagnostic endoscopy with a rigid endoscope perforation rate is 0.11 percent.
- Stricture dilation perforation rate is 0.09 to 2.2 percent.
- Sclerotherapy perforation rate is 1 to 5 percent.
- Pneumatic dilation for achalasia perforation rate is 2 to 6 percent.
- The incidence of perforation related to endoscopy increases with procedural complexity.
- Mortality rates due to perforation are 20 percent.
Colonic perforation[4]
- The incidence of colonic perforation (CP) could be as low as 0.016% of all diagnostic colonoscopy procedures and may be seen in up to 5% of therapeutic colonoscopies.
- The incidence of CP following flexible sigmoidoscopy varies from 0.027% to 0.088%.
- Rectal perforation during colonoscopy was reported to be around 0.01%.
- Screening colonoscopy perforation rates are 0.01 to 0.1 percent.
- Anastomotic stricture dilation perforation rates are 0 to 6 percent.
- Crohn's disease stricture dilation perforation rates are 0 to 18 percent.
- Stent placement perforation rates are 4 percent.
- Colonic decompression tube placement perforation rates are 2 percent.
- Colonic endoscopic mucosal resection perforation rates are 0 to 5 percent.
- Mortality rates from iatrogenic colonic perforation range from 0 to 0.65 percent. [60]
- The incidence of perforation during colonoscopy increases as the complexity of the procedure increases and is estimated at 1:1000 for therapeutic colonoscopy and 1:1400 for overall colonoscopies.
- The rectosigmoid area was most commonly perforated followed by the cecum, 53 percent and 24 percent, respectively. [141]
- Most perforations were due to blunt injury, 27 percent of perforations occurred with polypectomy, and 18 percent of perforations were produced by thermal injury.
References
- ↑ "Practice guidelines in cardiothoracic surgery. American Association for Thoracic Surgery, Society of Thoracic Surgeons, Southern Thoracic Surgical Association, Western Thoracic Surgical Association". Ann Thorac Surg. 56 (5): 1203–13. 1993. PMID 8239832.
- ↑ Hermansson M, Ekedahl A, Ranstam J, Zilling T (2009). "Decreasing incidence of peptic ulcer complications after the introduction of the proton pump inhibitors, a study of the Swedish population from 1974-2002". BMC Gastroenterol. 9: 25. doi:10.1186/1471-230X-9-25. PMC 2679757. PMID 19379513.
- ↑ Bhatia NL, Collins JM, Nguyen CC, Jaroszewski DE, Vikram HR, Charles JC (2008). "Esophageal perforation as a complication of esophagogastroduodenoscopy". J Hosp Med. 3 (3): 256–62. doi:10.1002/jhm.289. PMID 18570335.
- ↑ Lohsiriwat V, Sujarittanakarn S, Akaraviputh T, Lertakyamanee N, Lohsiriwat D, Kachinthorn U (2009). "What are the risk factors of colonoscopic perforation?". BMC Gastroenterol. 9: 71. doi:10.1186/1471-230X-9-71. PMC 2760570. PMID 19778446.
- ↑ Lohsiriwat V (2010). "Colonoscopic perforation: incidence, risk factors, management and outcome". World J Gastroenterol. 16 (4): 425–30. PMC 2811793. PMID 20101766.