Difference between revisions of "Mechanical bowel perforation"

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'''Mechanical bowel perforation''' is a relatively uncommon occurrence.  
'''Mechanical bowel perforation''' is a relatively uncommon occurrence.  


===General===
'''Bowel perforation''' redirects to this article.  This article covers the [[differential diagnosis]] of bowel perforation.
 
==General==
*Uncommon.
*Uncommon.


Causes:<ref name=pmid23212537>{{Cite journal  | last1 = Hines | first1 = J. | last2 = Rosenblat | first2 = J. | last3 = Duncan | first3 = DR. | last4 = Friedman | first4 = B. | last5 = Katz | first5 = DS. | title = Perforation of the mesenteric small bowel: etiologies and CT findings. | journal = Emerg Radiol | volume = 20 | issue = 2 | pages = 155-61 | month = Apr | year = 2013 | doi = 10.1007/s10140-012-1095-3 | PMID = 23212537 }}</ref>
===Causes of perforation===
*Iatrogenic, i.e. complication of a surgery.
Non-mechanical causes:<ref name=pmid23212537/>
*[[Inflammatory bowel disease]] - [[Crohn's disease]], toxic megacolon.
*[[Diverticular disease]].
*Malignancy - see ''[[tumour perforation in colorectal cancer]]''.
*Ischemia.
**[[Ischemic enteritis]].
**[[Ischemic colitis]].
*Duodenal ulcer.
 
Mechanical causes:<ref name=pmid23212537>{{Cite journal  | last1 = Hines | first1 = J. | last2 = Rosenblat | first2 = J. | last3 = Duncan | first3 = DR. | last4 = Friedman | first4 = B. | last5 = Katz | first5 = DS. | title = Perforation of the mesenteric small bowel: etiologies and CT findings. | journal = Emerg Radiol | volume = 20 | issue = 2 | pages = 155-61 | month = Apr | year = 2013 | doi = 10.1007/s10140-012-1095-3 | PMID = 23212537 }}</ref>
*Iatrogenic, e.g. complication of a surgery, colonscopy.
**Typically elderly.
**Typically elderly.
*Trauma, e.g. [[gunshot wound]], [[sharp force trauma]].
*Trauma, e.g. [[gunshot wound]], [[sharp force trauma]].
**Typically younger people that were "minding their own business".
**Typically younger people that were "minding their own business".
Other causes of perforation non-mechanical:<ref name=pmid23212537/>
*[[Crohn's disease]].
*[[Diverticular disease]].
*Foreign body.
*Foreign body.
*Malignancy.
*Ischemia.


===Gross===
==Gross==
*Fibrinous exudate.
*Fibrinous exudate.
*Bowel wall thickening, focal.
*Bowel wall thickening, focal.
*Perforation - may or may not be obvious.
*Perforation - may or may not be obvious.


===Microscopic===
Radiology:
*Free air.
 
==Microscopic==
Features:
Features:
*Microabscess formation - esp. at serosal aspect.
*Microabscess formation - esp. at serosal aspect.
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DDx:
DDx:
*Malignancy:
*Malignancy:
**[[Signet ring cell carcinoma]].
**[[Adenocarcinoma]], primary.
***[[Signet ring cell carcinoma]].
**Metastatic carcinoma.
**Metastatic carcinoma.
**Others.
*Other causes of [[small bowel obstruction]].
*Other causes of [[small bowel obstruction]].
==Sign out==
<pre>
ILEUM, BOWEL RESECTION:
- SMALL BOWEL WITH FOCAL TRANSMURAL INFLAMMATION, EDEMA, SEROSITIS AND EARLY
  MICROABSCESS FORMATION -- COMPATIBLE WITH PERFORATION.
- FIBROUS ADHESIONS.
- ONE BENIGN LYMPH NODE.
- NEGATIVE FOR MALIGNANCY.
</pre>


==See also==
==See also==
*[[Small intestine]].
*[[Small intestine]].
*[[Colon]].
*[[Colon]].
*[[Tumour perforation in colorectal cancer]].


==References==
==References==

Latest revision as of 20:49, 20 February 2017

Mechanical bowel perforation is a relatively uncommon occurrence.

Bowel perforation redirects to this article. This article covers the differential diagnosis of bowel perforation.

General

  • Uncommon.

Causes of perforation

Non-mechanical causes:[1]

Mechanical causes:[1]

  • Iatrogenic, e.g. complication of a surgery, colonscopy.
    • Typically elderly.
  • Trauma, e.g. gunshot wound, sharp force trauma.
    • Typically younger people that were "minding their own business".
  • Foreign body.

Gross

  • Fibrinous exudate.
  • Bowel wall thickening, focal.
  • Perforation - may or may not be obvious.

Radiology:

  • Free air.

Microscopic

Features:

  • Microabscess formation - esp. at serosal aspect.
  • Serositis.

DDx:

Sign out

ILEUM, BOWEL RESECTION:
- SMALL BOWEL WITH FOCAL TRANSMURAL INFLAMMATION, EDEMA, SEROSITIS AND EARLY 
  MICROABSCESS FORMATION -- COMPATIBLE WITH PERFORATION.
- FIBROUS ADHESIONS.
- ONE BENIGN LYMPH NODE.
- NEGATIVE FOR MALIGNANCY.

See also

References

  1. ↑ 1.0 1.1 Hines, J.; Rosenblat, J.; Duncan, DR.; Friedman, B.; Katz, DS. (Apr 2013). "Perforation of the mesenteric small bowel: etiologies and CT findings.". Emerg Radiol 20 (2): 155-61. doi:10.1007/s10140-012-1095-3. PMID 23212537.
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