Some Causes of Gastrointestinal Tract Perforation
Perforation Site | Cause | Comments |
|---|---|---|
All sites | Trauma | ― |
― | ||
Esophagus | Forceful vomiting | Termed Boerhaave syndrome |
Iatrogenic causes | Typically perforation with an esophagoscope, balloon dilator, or bougie | |
Ingestion of corrosive material | ― | |
Stomach or duodenum | Can occur in patients with no previous history of ulcer symptoms Sometimes no free air is visible on radiograph | |
Ingestion of corrosive material | Typically stomach | |
Intestine | ― | |
Possibly acute appendicitis and Meckel diverticulitis | Free air rarely visible on radiographs | |
Colon | Obstruction | Typically perforates at cecum High risk: Colon ≥ 13 cm diameter, patients receiving prednisone or other immunosuppressants (symptoms and signs may be minimal in this group) |
― | ||
Inflammatory bowel disease (ulcerative colitis, Crohn disease) | ― | |
― | ||
Sometimes spontaneous | ― | |
Gallbladder | Iatrogenic injury during cholecystectomy or liver biopsy | Usually the biliary tree or duodenum is injured |
Rarely, acute cholecystitis | Usually walled off by omentum |