Difference between revisions of "Mechanical bowel perforation"
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*Duodenal ulcer. | *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> | 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. | *Iatrogenic, e.g. complication of a surgery, colonscopy. | ||
Revision as of 18:51, 21 February 2014
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.
- 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.
Microscopic
Features:
- Microabscess formation - esp. at serosal aspect.
- Serositis.
DDx:
- Malignancy:
- Signet ring cell carcinoma.
- Metastatic carcinoma.
- Other causes of small bowel obstruction.