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. | ||
'''Bowel perforation''' redirects to this article. This article covers the [[differential diagnosis]] of bowel perforation. | |||
==General== | ==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, | 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". | ||
*Foreign body. | *Foreign body. | ||
==Gross== | ==Gross== | ||
| Line 23: | Line 27: | ||
*Bowel wall thickening, focal. | *Bowel wall thickening, focal. | ||
*Perforation - may or may not be obvious. | *Perforation - may or may not be obvious. | ||
Radiology: | |||
*Free air. | |||
==Microscopic== | ==Microscopic== | ||
| Line 31: | Line 38: | ||
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]
- Inflammatory bowel disease - Crohn's disease, toxic megacolon.
- Diverticular disease.
- Malignancy - see tumour perforation in colorectal cancer.
- Ischemia.
- Duodenal ulcer.
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:
- Malignancy:
- Adenocarcinoma, primary.
- Metastatic carcinoma.
- Others.
- Other causes of small bowel obstruction.
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.