Mechanical bowel perforation

Mechanical bowel perforation is a relatively uncommon occurrence.

General

• Uncommon.

Causes:

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

Other causes of perforation non-mechanical:

• Crohn's disease.
• Diverticular disease.
• Foreign body.
• Malignancy.
• Ischemia.
  • Ischemic enteritis.
  • Ischemic colitis.

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.

See also

• Small intestine.
• Colon.