Mechanical bowel perforation

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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:

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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.