Gastrointestinal perforation causes: Difference between revisions

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{{Gastrointestinal perforation}}


==Overview==
==Overview==
Immune-mediated or inflammatory
Instrumentation of the gastrointestinal tract includes upper endoscopy, sigmoidoscopy, colonoscopy, stent placement, endoscopic sclerotherapy, nasogastric intubation, esophageal dilation, and surgery is the commonest cause of gastrointestinal perforation. Other causes include medications, foreign bodies, violent retching, [[Peptic ulcer disease]]. Perforation of the [[small intestine]] can be related to [[bowel obstruction]], [[acute mesenteric ischemia]], [[inflammatory bowel disease]]. Colonic [[diverticulosis]] is common cause of perforation in large intestine. Causes of spontaneous intestinal perforation in adults include [[Crohn's disease|Crohn’s disease]], [[Celiac disease]], [[Graft-versus-host disease|graft-''vs''-host disease]], and [[infection]]. Causes of intestinal perforation in neonates include [[Necrotising enterocolitis]], [[Iatrogenic]], umbilical catheterization, u[[Umbilical cord|mbilical cord]] clamping, [[Nasogastric intubation|nasogastric tube]], [[Obstruction]], and ileal [[atresia]].
Crohn’s disease (CD)
 
Celiac disease or gluten-sensitive enteropathy (GSE)
== Gastrointestinal perforation causes ==
Collagenous sprue
 
Graft-vs-host disease (GVHD)
=== Causes of gastrointestinal perforation in adults ===
Infections
 
Viral: Cytomegalovirus (CMV)
====='''Instrumentation'''=====
Bacteria: Salmonella paratyphi, mycobacterium tuberculosis
*Instrumentation of the gastrointestinal tract includes upper endoscopy, sigmoidoscopy, colonoscopy, stent placement, endoscopic sclerotherapy, nasogastric intubation, esophageal dilation, and surgery.<ref name="pmid19496201">{{cite journal| author=Akbulut S, Cakabay B, Ozmen CA, Sezgin A, Sevinc MM| title=An unusual cause of ileal perforation: report of a case and literature review. | journal=World J Gastroenterol | year= 2009 | volume= 15 | issue= 21 | pages= 2672-4 | pmid=19496201 | doi= | pmc=2691502 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19496201  }}</ref>
Parasites: Ascaris lumbricoides
*The area of the esophagus at most risk for instrumental perforation is Killian's triangle, which is the part of the pharynx formed by the inferior pharyngeal constrictor and cricopharyngeus muscle.
Protozoa: Entameba histolytica
*Gastrointestinal leakage can also occur postoperatively as a result of anastomotic breakdown.<ref name="pmid24074406">{{cite journal| author=Rickles AS, Iannuzzi JC, Kelly KN, Cooney RN, Brown DA, Davidson M et al.| title=Anastomotic leak or organ space surgical site infection: What are we missing in our quality improvement programs? | journal=Surgery | year= 2013 | volume= 154 | issue= 4 | pages= 680-7; discussion 687-9 | pmid=24074406 | doi=10.1016/j.surg.2013.06.035 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24074406  }}</ref>
Drugs and biological agents
*[[Immunosuppressed]] individuals may be at increased risk for dehiscence and deep organ space infection following surgery.<ref name="pmid21367368">{{cite journal| author=Ismael H, Horst M, Farooq M, Jordon J, Patton JH, Rubinfeld IS| title=Adverse effects of preoperative steroid use on surgical outcomes. | journal=Am J Surg | year= 2011 | volume= 201 | issue= 3 | pages= 305-8; discussion 308-9 | pmid=21367368 | doi=10.1016/j.amjsurg.2010.09.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21367368  }}</ref>
NSAIDs: Indomethacin
=====Other causes=====
Enteric-coated potassium chloride
*Medications: [[aspirin]], [[potassium]], [[Disease-modifying antirheumatic drug|disease-modifying antirheumatic drugs]], and [[non-steroidal anti-inflammatory drug]] use has been associated with perforation.<ref name="pmid14515298">{{cite journal| author=Morris CR, Harvey IM, Stebbings WS, Speakman CT, Kennedy HJ, Hart AR| title=Anti-inflammatory drugs, analgesics and the risk of perforated colonic diverticular disease. | journal=Br J Surg | year= 2003 | volume= 90 | issue= 10 | pages= 1267-72 | pmid=14515298 | doi=10.1002/bjs.4221 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14515298  }}</ref>
Chemotherapy (?steroids)
*Foreign bodies such as sharp objects, food with sharp surfaces, or gastric bezoar.<ref name="pmid27405509">{{cite journal| author=Strangfeld A, Richter A, Siegmund B, Herzer P, Rockwitz K, Demary W et al.| title=Risk for lower intestinal perforations in patients with rheumatoid arthritis treated with tocilizumab in comparison to treatment with other biologic or conventional synthetic DMARDs. | journal=Ann Rheum Dis | year= 2017 | volume= 76 | issue= 3 | pages= 504-510 | pmid=27405509 | doi=10.1136/annrheumdis-2016-209773 | pmc=5445993 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27405509  }}</ref>
Monoclonal antibodies: Bevicuzimab
*Violent retching can lead to spontaneous esophageal perforation, known as [[Boerhaave syndrome]] due to increased intraesophageal pressure in the lower esophagus.
Congenital
*[[Peptic ulcer disease]] is the most common cause of [[stomach]] and duodenal perforation.<ref name="pmid26460663">{{cite journal |vauthors=Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, Søreide JA |title=Perforated peptic ulcer |journal=Lancet |volume=386 |issue=10000 |pages=1288–1298 |date=September 2015 |pmid=26460663 |pmc=4618390 |doi=10.1016/S0140-6736(15)00276-7 |url=}}</ref>
Meckel’s diverticulum
*Marginal ulcers may complicate procedures involving a [[gastrojejunostomy]].
Jejunal or ileal duplications
*Perforated [[gastric ulcer]] is associated with a higher mortality.<ref name="pmid17993968">{{cite journal| author=Wu JT, Mattox KL, Wall MJ| title=Esophageal perforations: new perspectives and treatment paradigms. | journal=J Trauma | year= 2007 | volume= 63 | issue= 5 | pages= 1173-84 | pmid=17993968 | doi=10.1097/TA.0b013e31805c0dd4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17993968  }}</ref>
Metabolic
 
Homocystinuria
====='''Small intestine causes'''=====
Vascular
*Perforation of the [[small intestine]] can be related to [[bowel obstruction]], [[acute mesenteric ischemia]], [[inflammatory bowel disease]].<ref name="pmid12725136">{{cite journal| author=Werbin N, Haddad R, Greenberg R, Karin E, Skornick Y| title=Free perforation in Crohn's disease. | journal=Isr Med Assoc J | year= 2003 | volume= 5 | issue= 3 | pages= 175-7 | pmid=12725136 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12725136  }}</ref>
Wegener’s granulomatosis
*[[Abdominal wall hernia|Abdominal wall]], [[Groin hernia|groin]], [[Diaphragmatic hernia|diaphragmatic]], [[internal hernia]], paraesophageal hernia, and [[volvulus]] can all lead to perforation either related to bowel wall ischemia.
Giant cell arteritis
*Injuries to the small intestine during laparoscopic procedures are often not recognized during the procedure.
Allergic granulomatous arteritis (i.e., Churg-Strauss syndrome)
*[[Crohn's disease]] has a propensity to perforate slowly, leading to formation of entero-enteric or enterocutaneous [[fistula]] formation.
Henoch-schonlein purpura
 
Buerger’s disease
*Diseases such as [[Typhoid fever|typhoid]], [[tuberculosis]], or [[schistosomiasis]] can perforate the small intestine.
Atherosclerotic vascular occlusion
*The perforations usually occur in the ileum at necrotic [[Peyer's patches]].<ref name="pmid20555055">{{cite journal| author=Singh NG, Mannan AA, Kahvic M, Alanzi FM| title=Jejunal perforation caused by schistosomiasis. | journal=Trop Doct | year= 2010 | volume= 40 | issue= 3 | pages= 191-2 | pmid=20555055 | doi=10.1258/td.2010.090352 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20555055  }}</ref>
Radiation-induced vascular injury
=====Large intestine causes=====
Neoplasm
*Colonic [[diverticulosis]] is common in the developed world. They can become inflamed and perforate and may lead to [[abscess]] formation.<ref name="pmid12496319">{{cite journal |vauthors=Morris CR, Harvey IM, Stebbings WS, Speakman CT, Kennedy HJ, Hart AR |title=Epidemiology of perforated colonic diverticular disease |journal=Postgrad Med J |volume=78 |issue=925 |pages=654–8 |date=November 2002 |pmid=12496319 |pmc=1742564 |doi= |url=}}</ref>
Primary (adenocarcinoma, EATCL, angiosarcoma)
*[[Mesenteric ischemia]] increases the risk for perforation. [[Embolism]], mesenteric occlusive disease, and [[heart failure]] lead to gastrointestinal ischemia.
Secondary (melanoma, breast, mesothelioma, lung)
*[[Neoplasm|Neoplasms]] can perforate by direct penetration and [[necrosis]], or by producing obstruction.<ref name="pmid17420936">{{cite journal| author=Ara C, Coban S, Kayaalp C, Yilmaz S, Kirimlioglu V| title=Spontaneous intestinal perforation due to non-Hodgkin's lymphoma: evaluation of eight cases. | journal=Dig Dis Sci | year= 2007 | volume= 52 | issue= 8 | pages= 1752-6 | pmid=17420936 | doi=10.1007/s10620-006-9279-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17420936  }}</ref>
 
=== Causes of spontaneous intestinal perforation in adults<ref name="pmid11503101">{{cite journal| author=Gordon PV, Young ML, Marshall DD| title=Focal small bowel perforation: an adverse effect of early postnatal dexamethasone therapy in extremely low birth weight infants. | journal=J Perinatol | year= 2001 | volume= 21 | issue= 3 | pages= 156-60 | pmid=11503101 | doi=10.1038/sj.jp.7200520 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11503101  }}</ref> ===
* [[Crohn's disease|Crohn’s disease]]<ref name="pmid16505755">{{cite journal |vauthors=Brihier H, Nion-Larmurier I, Afchain P, Tiret E, Beaugerie L, Gendre JP, Cosnes J |title=Intestinal perforation in Crohn's disease. Factors predictive of surgical resection |journal=Gastroenterol. Clin. Biol. |volume=29 |issue=11 |pages=1105–11 |date=November 2005 |pmid=16505755 |doi= |url=}}</ref>
* [[Celiac disease]]<ref name="pmid25110427">{{cite journal |vauthors=Freeman HJ |title=Spontaneous free perforation of the small intestine in adults |journal=World J. Gastroenterol. |volume=20 |issue=29 |pages=9990–7 |date=August 2014 |pmid=25110427 |pmc=4123378 |doi=10.3748/wjg.v20.i29.9990 |url=}}</ref>
* [[Graft-versus-host disease|Graft-''vs''-host disease]]<ref name="pmid23101995">{{cite journal |vauthors=Palaniappa NC, Doyon L, Divino CM |title=Colonic perforation in graft versus host disease: a case report |journal=Int Surg |volume=97 |issue=1 |pages=14–6 |date=2012 |pmid=23101995 |pmc=3723188 |doi=10.9738/CC76.1 |url=}}</ref>
* Infections:
* Viral: [[Cytomegalovirus]]<ref name="pmid2173658">{{cite journal |vauthors=Kram HB, Shoemaker WC |title=Intestinal perforation due to cytomegalovirus infection in patients with AIDS |journal=Dis. Colon Rectum |volume=33 |issue=12 |pages=1037–40 |date=December 1990 |pmid=2173658 |doi= |url=}}</ref>
* Bacteria: [[Salmonella paratyphi]], [[mycobacterium tuberculosis]]<ref name="pmid10695758">{{cite journal |vauthors=Stoner MC, Forsythe R, Mills AS, Ivatury RR, Broderick TJ |title=Intestinal perforation secondary to Salmonella typhi: case report and review of the literature |journal=Am Surg |volume=66 |issue=2 |pages=219–22 |date=February 2000 |pmid=10695758 |doi= |url=}}</ref><ref name="pmid22696633">{{cite journal |vauthors=Dunne JA, Wilson J, Gokhale J |title=Small bowel perforation secondary to enteric Salmonella paratyphi A infection |journal=BMJ Case Rep |volume=2011 |issue= |pages= |date=April 2011 |pmid=22696633 |pmc=3082069 |doi=10.1136/bcr.08.2010.3272 |url=}}</ref><ref name="pmid21341138">{{cite journal |vauthors=Coccolini F, Ansaloni L, Catena F, Lazzareschi D, Puviani L, Pinna AD |title=Tubercular bowel perforation: what to do? |journal=Ulus Travma Acil Cerrahi Derg |volume=17 |issue=1 |pages=66–74 |date=January 2011 |pmid=21341138 |doi= |url=}}</ref><ref name="pmid15797233">{{cite journal |vauthors=Ara C, Sogutlu G, Yildiz R, Kocak O, Isik B, Yilmaz S, Kirimlioglu V |title=Spontaneous small bowel perforations due to intestinal tuberculosis should not be repaired by simple closure |journal=J. Gastrointest. Surg. |volume=9 |issue=4 |pages=514–7 |date=April 2005 |pmid=15797233 |doi=10.1016/j.gassur.2004.09.034 |url=}}</ref>
* Parasites: [[Ascaris lumbricoides]]<ref name="pmid22869977">{{cite journal |vauthors=Ramareddy RS, Alladi A, Siddapa OS, Deepti V, Akthar T, Mamata B |title=Surgical complications of Ascaris lumbricoides in children |journal=J Indian Assoc Pediatr Surg |volume=17 |issue=3 |pages=116–9 |date=July 2012 |pmid=22869977 |pmc=3409899 |doi=10.4103/0971-9261.98130 |url=}}</ref>
* Protozoa: [[Amoebiasis|Entameba histolytica]]<ref name="pmid10756002">{{cite journal |vauthors=Espinosa-Cantellano M, Martínez-Palomo A |title=Pathogenesis of intestinal amebiasis: from molecules to disease |journal=Clin. Microbiol. Rev. |volume=13 |issue=2 |pages=318–31 |date=April 2000 |pmid=10756002 |pmc=100155 |doi= |url=}}</ref>
* Drugs: [[Non-steroidal anti-inflammatory drug|NSAIDs]] and [[indomethacin]]<ref name="pmid27763630">{{cite journal| author=Stavel M, Wong J, Cieslak Z, Sherlock R, Claveau M, Shah PS| title=Effect of prophylactic indomethacin administration and early feeding on spontaneous intestinal perforation in extremely low-birth-weight infants. | journal=J Perinatol | year= 2017 | volume= 37 | issue= 2 | pages= 188-193 | pmid=27763630 | doi=10.1038/jp.2016.196 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27763630  }}</ref><ref name="pmid24267289">{{cite journal |vauthors=Sostres C, Gargallo CJ, Lanas A |title=Nonsteroidal anti-inflammatory drugs and upper and lower gastrointestinal mucosal damage |journal=Arthritis Res. Ther. |volume=15 Suppl 3 |issue= |pages=S3 |date=2013 |pmid=24267289 |pmc=3890944 |doi=10.1186/ar4175 |url=}}</ref><ref name="pmid22253945">{{cite journal |vauthors=Al-Saeed A |title=Gastrointestinal and Cardiovascular Risk of Nonsteroidal Anti-inflammatory Drugs |journal=Oman Med J |volume=26 |issue=6 |pages=385–91 |date=November 2011 |pmid=22253945 |pmc=3251190 |doi=10.5001/omj.2011.101 |url=}}</ref>
* Enteric-coated [[Potassium chlorate|potassium chloride]]<ref name="pmid6127542">{{cite journal |vauthors=McMahon FG, Ryan JR, Akdamar K, Ertan A |title=Upper gastrointestinal lesions after potassium chloride supplements: a controlled clinical trial |journal=Lancet |volume=2 |issue=8307 |pages=1059–61 |date=November 1982 |pmid=6127542 |doi= |url=}}</ref><ref name="pmid1148734">{{cite journal |vauthors=Farquharson-Roberts MA, Giddings AE, Nunn AJ |title=Perforation of small bowel due to slow release potassium chloride (slow-K) |journal=Br Med J |volume=3 |issue=5977 |pages=206 |date=July 1975 |pmid=1148734 |pmc=1674080 |doi= |url=}}</ref>
* [[Monoclonal antibodies]]: [[Bevacizumab]]<ref name="pmid17198092">{{cite journal |vauthors=Smith FO, Goff SL, Klapper JA, Levy C, Allen T, Mavroukakis SA, Rosenberg SA |title=Risk of bowel perforation in patients receiving interleukin-2 after therapy with anti-CTLA 4 monoclonal antibody |journal=J. Immunother. |volume=30 |issue=1 |pages=130 |date=January 2007 |pmid=17198092 |pmc=2151199 |doi=10.1097/01.cji.0000211334.06762.89 |url=}}</ref>
* [[Meckel's diverticulum|Meckel’s diverticulum]]<ref name="pmid26175810">{{cite journal |vauthors=Farah RH, Avala P, Khaiz D, Bensardi F, Elhattabi K, Lefriyekh R, Berrada S, Fadil A, Zerouali NO |title=Spontaneous perforation of Meckel's diverticulum: a case report and review of literature |journal=Pan Afr Med J |volume=20 |issue= |pages=319 |date=2015 |pmid=26175810 |pmc=4491457 |doi=10.11604/pamj.2015.20.319.5980 |url=}}</ref><ref name="pmid21373322">{{cite journal |vauthors=Kloss BT, Broton CE, Sullivan AM |title=Perforated Meckel diverticulum |journal=Int J Emerg Med |volume=3 |issue=4 |pages=455–7 |date=August 2010 |pmid=21373322 |pmc=3047846 |doi=10.1007/s12245-010-0213-9 |url=}}</ref>
 
* Radiation-induced vascular injury
* [[Atherosclerosis|Atherosclerotic]] vascular occlusion
* [[Buergers disease|Buerger’s disease]]
* [[Giant cell arteritis]]
* [[Wegener's granulomatosis|Wegener’s granulomatosis]]
* [[Henoch-Schönlein purpura|Henoch-schonlein purpura]]
* Allergic granulomatous arteritis
 
=== Causes of intestinal perforation in neonates ===
Intestinal perforation in [[neonates]] may be caused due to the following conditions:<ref name="pmid23031751">{{cite journal |vauthors=Daliya P, White TJ, Makhdoomi KR |title=Gastric perforation in an adult male following nasogastric intubation |journal=Ann R Coll Surg Engl |volume=94 |issue=7 |pages=e210–2 |date=October 2012 |pmid=23031751 |pmc=3954270 |doi=10.1308/003588412X13171221502347 |url=}}</ref><ref name="pmid26023450">{{cite journal |vauthors=Hyginus EO, Jideoffor U, Victor M, N OA |title=Gastrointestinal perforation in neonates: aetiology and risk factors |journal=J Neonatal Surg |volume=2 |issue=3 |pages=30 |date=2013 |pmid=26023450 |pmc=4422271 |doi= |url=}}</ref>
* [[Necrotising enterocolitis]]
* Spontaneous
* [[Iatrogenic]]
* Umbilical catheterization
* [[Umbilical cord]] clamping
* [[Nasogastric intubation|Nasogastric tube]]
* [[Obstruction]]
* Ileal [[atresia]]
* [[Gastric volvulus]]
* [[Gastroschisis]]
* Perforated [[inguinal hernia]]
* Malrotation/[[midgut volvulus]]
* Congenital band


==References==
==References==
{{Reflist|2}}

Latest revision as of 20:28, 1 March 2018


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

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Overview

Instrumentation of the gastrointestinal tract includes upper endoscopy, sigmoidoscopy, colonoscopy, stent placement, endoscopic sclerotherapy, nasogastric intubation, esophageal dilation, and surgery is the commonest cause of gastrointestinal perforation. Other causes include medications, foreign bodies, violent retching, Peptic ulcer disease. Perforation of the small intestine can be related to bowel obstruction, acute mesenteric ischemia, inflammatory bowel disease. Colonic diverticulosis is common cause of perforation in large intestine. Causes of spontaneous intestinal perforation in adults include Crohn’s disease, Celiac disease, graft-vs-host disease, and infection. Causes of intestinal perforation in neonates include Necrotising enterocolitis, Iatrogenic, umbilical catheterization, umbilical cord clamping, nasogastric tube, Obstruction, and ileal atresia.

Gastrointestinal perforation causes

Causes of gastrointestinal perforation in adults

Instrumentation
  • Instrumentation of the gastrointestinal tract includes upper endoscopy, sigmoidoscopy, colonoscopy, stent placement, endoscopic sclerotherapy, nasogastric intubation, esophageal dilation, and surgery.[1]
  • The area of the esophagus at most risk for instrumental perforation is Killian's triangle, which is the part of the pharynx formed by the inferior pharyngeal constrictor and cricopharyngeus muscle.
  • Gastrointestinal leakage can also occur postoperatively as a result of anastomotic breakdown.[2]
  • Immunosuppressed individuals may be at increased risk for dehiscence and deep organ space infection following surgery.[3]
Other causes
Small intestine causes
Large intestine causes

Causes of spontaneous intestinal perforation in adults[12]

Causes of intestinal perforation in neonates

Intestinal perforation in neonates may be caused due to the following conditions:[31][32]

References

  1. ↑ Akbulut S, Cakabay B, Ozmen CA, Sezgin A, Sevinc MM (2009). "An unusual cause of ileal perforation: report of a case and literature review". World J Gastroenterol. 15 (21): 2672–4. PMC 2691502. PMID 19496201.
  2. ↑ Rickles AS, Iannuzzi JC, Kelly KN, Cooney RN, Brown DA, Davidson M; et al. (2013). "Anastomotic leak or organ space surgical site infection: What are we missing in our quality improvement programs?". Surgery. 154 (4): 680–7, discussion 687-9. doi:10.1016/j.surg.2013.06.035. PMID 24074406.
  3. ↑ Ismael H, Horst M, Farooq M, Jordon J, Patton JH, Rubinfeld IS (2011). "Adverse effects of preoperative steroid use on surgical outcomes". Am J Surg. 201 (3): 305–8, discussion 308-9. doi:10.1016/j.amjsurg.2010.09.018. PMID 21367368.
  4. ↑ Morris CR, Harvey IM, Stebbings WS, Speakman CT, Kennedy HJ, Hart AR (2003). "Anti-inflammatory drugs, analgesics and the risk of perforated colonic diverticular disease". Br J Surg. 90 (10): 1267–72. doi:10.1002/bjs.4221. PMID 14515298.
  5. ↑ Strangfeld A, Richter A, Siegmund B, Herzer P, Rockwitz K, Demary W; et al. (2017). "Risk for lower intestinal perforations in patients with rheumatoid arthritis treated with tocilizumab in comparison to treatment with other biologic or conventional synthetic DMARDs". Ann Rheum Dis. 76 (3): 504–510. doi:10.1136/annrheumdis-2016-209773. PMC 5445993. PMID 27405509.
  6. ↑ Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, Søreide JA (September 2015). "Perforated peptic ulcer". Lancet. 386 (10000): 1288–1298. doi:10.1016/S0140-6736(15)00276-7. PMC 4618390. PMID 26460663.
  7. ↑ Wu JT, Mattox KL, Wall MJ (2007). "Esophageal perforations: new perspectives and treatment paradigms". J Trauma. 63 (5): 1173–84. doi:10.1097/TA.0b013e31805c0dd4. PMID 17993968.
  8. ↑ Werbin N, Haddad R, Greenberg R, Karin E, Skornick Y (2003). "Free perforation in Crohn's disease". Isr Med Assoc J. 5 (3): 175–7. PMID 12725136.
  9. ↑ Singh NG, Mannan AA, Kahvic M, Alanzi FM (2010). "Jejunal perforation caused by schistosomiasis". Trop Doct. 40 (3): 191–2. doi:10.1258/td.2010.090352. PMID 20555055.
  10. ↑ Morris CR, Harvey IM, Stebbings WS, Speakman CT, Kennedy HJ, Hart AR (November 2002). "Epidemiology of perforated colonic diverticular disease". Postgrad Med J. 78 (925): 654–8. PMC 1742564. PMID 12496319.
  11. ↑ Ara C, Coban S, Kayaalp C, Yilmaz S, Kirimlioglu V (2007). "Spontaneous intestinal perforation due to non-Hodgkin's lymphoma: evaluation of eight cases". Dig Dis Sci. 52 (8): 1752–6. doi:10.1007/s10620-006-9279-x. PMID 17420936.
  12. ↑ Gordon PV, Young ML, Marshall DD (2001). "Focal small bowel perforation: an adverse effect of early postnatal dexamethasone therapy in extremely low birth weight infants". J Perinatol. 21 (3): 156–60. doi:10.1038/sj.jp.7200520. PMID 11503101.
  13. ↑ Brihier H, Nion-Larmurier I, Afchain P, Tiret E, Beaugerie L, Gendre JP, Cosnes J (November 2005). "Intestinal perforation in Crohn's disease. Factors predictive of surgical resection". Gastroenterol. Clin. Biol. 29 (11): 1105–11. PMID 16505755.
  14. ↑ Freeman HJ (August 2014). "Spontaneous free perforation of the small intestine in adults". World J. Gastroenterol. 20 (29): 9990–7. doi:10.3748/wjg.v20.i29.9990. PMC 4123378. PMID 25110427.
  15. ↑ Palaniappa NC, Doyon L, Divino CM (2012). "Colonic perforation in graft versus host disease: a case report". Int Surg. 97 (1): 14–6. doi:10.9738/CC76.1. PMC 3723188. PMID 23101995.
  16. ↑ Kram HB, Shoemaker WC (December 1990). "Intestinal perforation due to cytomegalovirus infection in patients with AIDS". Dis. Colon Rectum. 33 (12): 1037–40. PMID 2173658.
  17. ↑ Stoner MC, Forsythe R, Mills AS, Ivatury RR, Broderick TJ (February 2000). "Intestinal perforation secondary to Salmonella typhi: case report and review of the literature". Am Surg. 66 (2): 219–22. PMID 10695758.
  18. ↑ Dunne JA, Wilson J, Gokhale J (April 2011). "Small bowel perforation secondary to enteric Salmonella paratyphi A infection". BMJ Case Rep. 2011. doi:10.1136/bcr.08.2010.3272. PMC 3082069. PMID 22696633.
  19. ↑ Coccolini F, Ansaloni L, Catena F, Lazzareschi D, Puviani L, Pinna AD (January 2011). "Tubercular bowel perforation: what to do?". Ulus Travma Acil Cerrahi Derg. 17 (1): 66–74. PMID 21341138.
  20. ↑ Ara C, Sogutlu G, Yildiz R, Kocak O, Isik B, Yilmaz S, Kirimlioglu V (April 2005). "Spontaneous small bowel perforations due to intestinal tuberculosis should not be repaired by simple closure". J. Gastrointest. Surg. 9 (4): 514–7. doi:10.1016/j.gassur.2004.09.034. PMID 15797233.
  21. ↑ Ramareddy RS, Alladi A, Siddapa OS, Deepti V, Akthar T, Mamata B (July 2012). "Surgical complications of Ascaris lumbricoides in children". J Indian Assoc Pediatr Surg. 17 (3): 116–9. doi:10.4103/0971-9261.98130. PMC 3409899. PMID 22869977.
  22. ↑ Espinosa-Cantellano M, Martínez-Palomo A (April 2000). "Pathogenesis of intestinal amebiasis: from molecules to disease". Clin. Microbiol. Rev. 13 (2): 318–31. PMC 100155. PMID 10756002.
  23. ↑ Stavel M, Wong J, Cieslak Z, Sherlock R, Claveau M, Shah PS (2017). "Effect of prophylactic indomethacin administration and early feeding on spontaneous intestinal perforation in extremely low-birth-weight infants". J Perinatol. 37 (2): 188–193. doi:10.1038/jp.2016.196. PMID 27763630.
  24. ↑ Sostres C, Gargallo CJ, Lanas A (2013). "Nonsteroidal anti-inflammatory drugs and upper and lower gastrointestinal mucosal damage". Arthritis Res. Ther. 15 Suppl 3: S3. doi:10.1186/ar4175. PMC 3890944. PMID 24267289.
  25. ↑ Al-Saeed A (November 2011). "Gastrointestinal and Cardiovascular Risk of Nonsteroidal Anti-inflammatory Drugs". Oman Med J. 26 (6): 385–91. doi:10.5001/omj.2011.101. PMC 3251190. PMID 22253945.
  26. ↑ McMahon FG, Ryan JR, Akdamar K, Ertan A (November 1982). "Upper gastrointestinal lesions after potassium chloride supplements: a controlled clinical trial". Lancet. 2 (8307): 1059–61. PMID 6127542.
  27. ↑ Farquharson-Roberts MA, Giddings AE, Nunn AJ (July 1975). "Perforation of small bowel due to slow release potassium chloride (slow-K)". Br Med J. 3 (5977): 206. PMC 1674080. PMID 1148734.
  28. ↑ Smith FO, Goff SL, Klapper JA, Levy C, Allen T, Mavroukakis SA, Rosenberg SA (January 2007). "Risk of bowel perforation in patients receiving interleukin-2 after therapy with anti-CTLA 4 monoclonal antibody". J. Immunother. 30 (1): 130. doi:10.1097/01.cji.0000211334.06762.89. PMC 2151199. PMID 17198092.
  29. ↑ Farah RH, Avala P, Khaiz D, Bensardi F, Elhattabi K, Lefriyekh R, Berrada S, Fadil A, Zerouali NO (2015). "Spontaneous perforation of Meckel's diverticulum: a case report and review of literature". Pan Afr Med J. 20: 319. doi:10.11604/pamj.2015.20.319.5980. PMC 4491457. PMID 26175810.
  30. ↑ Kloss BT, Broton CE, Sullivan AM (August 2010). "Perforated Meckel diverticulum". Int J Emerg Med. 3 (4): 455–7. doi:10.1007/s12245-010-0213-9. PMC 3047846. PMID 21373322.
  31. ↑ Daliya P, White TJ, Makhdoomi KR (October 2012). "Gastric perforation in an adult male following nasogastric intubation". Ann R Coll Surg Engl. 94 (7): e210–2. doi:10.1308/003588412X13171221502347. PMC 3954270. PMID 23031751.
  32. ↑ Hyginus EO, Jideoffor U, Victor M, N OA (2013). "Gastrointestinal perforation in neonates: aetiology and risk factors". J Neonatal Surg. 2 (3): 30. PMC 4422271. PMID 26023450.
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