Gastrointestinal perforation epidemiology and demographics: Difference between revisions
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=Overview= | =Overview= | ||
===== Esophageal perforation ===== | ===== Esophageal perforation<ref name="pmid8239832">{{cite journal| author=| title=Practice guidelines in cardiothoracic surgery. American Association for Thoracic Surgery, Society of Thoracic Surgeons, Southern Thoracic Surgical Association, Western Thoracic Surgical Association. | journal=Ann Thorac Surg | year= 1993 | volume= 56 | issue= 5 | pages= 1203-13 | pmid=8239832 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8239832 }}</ref> ===== | ||
* The incidence of iatrogenic perforation from | * The incidence of [[Iatrogenesis|iatrogenic]] [[esophageal]] perforation from instrumentation has decreased, but the number of esophageal perforations from external trauma and spontaneous rupture has increased. | ||
* In the period from 1950 to 1954 there was 1 perforation per 20,000 admissions. | * In the period from 1950 to 1954 there was 1 perforation per 20,000 admissions. | ||
* The incidence has now risen to 1 per 8,000 admissions. | * The incidence has now risen to 1 per 8,000 admissions. | ||
===== Peptic perforation ===== | ===== Peptic perforation<ref name="pmid19379513">{{cite journal| author=Hermansson M, Ekedahl A, Ranstam J, Zilling T| title=Decreasing incidence of peptic ulcer complications after the introduction of the proton pump inhibitors, a study of the Swedish population from 1974-2002. | journal=BMC Gastroenterol | year= 2009 | volume= 9 | issue= | pages= 25 | pmid=19379513 | doi=10.1186/1471-230X-9-25 | pmc=2679757 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19379513 }}</ref> ===== | ||
* There is lower incidence of peptic ulcer complications during the later years. | * There is lower incidence of [[peptic ulcer]] complications during the later years. | ||
* Incidence rates varied from 1.5 to 7.8/100000 per year regarding perforated peptic ulcers and from 5.2 to 40.2 regarding peptic ulcer bleeding. | * Incidence rates varied from 1.5 to 7.8/100000 per year regarding perforated peptic ulcers and from 5.2 to 40.2 regarding peptic ulcer [[bleeding]]. | ||
===== Upper endodcopy-related GIT perforation ===== | ===== Upper endodcopy-related GIT perforation<ref name="pmid18570335">{{cite journal| author=Bhatia NL, Collins JM, Nguyen CC, Jaroszewski DE, Vikram HR, Charles JC| title=Esophageal perforation as a complication of esophagogastroduodenoscopy. | journal=J Hosp Med | year= 2008 | volume= 3 | issue= 3 | pages= 256-62 | pmid=18570335 | doi=10.1002/jhm.289 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18570335 }}</ref> ===== | ||
* A perforation rate of 0.11 percent for rigid endoscopy contrasts with a 0.03 percent rate for flexible endoscopy | * A perforation rate of 0.11 percent for [[Endoscopy|rigid endoscopy]] contrasts with a 0.03 percent rate for flexible endoscopy. | ||
* Diagnostic endoscopy with a flexible endoscope | * Diagnostic endoscopy with a flexible endoscope perforation rate is 0.03 percent. | ||
* Diagnostic endoscopy with a rigid endoscope | * Diagnostic endoscopy with a rigid endoscope perforation rate is 0.11 percent. | ||
* Stricture dilation | * [[Stricture]] dilation perforation rate is 0.09 to 2.2 percent. | ||
* Sclerotherapy | * [[Sclerotherapy]] perforation rate is 1 to 5 percent. | ||
* Pneumatic dilation for achalasia | * [[Pneumatic tube|Pneumatic dilation]] for [[achalasia]] perforation rate is 2 to 6 percent. | ||
* The incidence of perforation related to endoscopy increases with procedural complexity | * The incidence of perforation related to endoscopy increases with procedural complexity. | ||
* Mortality rates are 20 percent. | * Mortality rates due to perforation are 20 percent. | ||
===== Colonic perforation ===== | ===== Colonic perforation<ref name="pmid19778446">{{cite journal| author=Lohsiriwat V, Sujarittanakarn S, Akaraviputh T, Lertakyamanee N, Lohsiriwat D, Kachinthorn U| title=What are the risk factors of colonoscopic perforation? | journal=BMC Gastroenterol | year= 2009 | volume= 9 | issue= | pages= 71 | pmid=19778446 | doi=10.1186/1471-230X-9-71 | pmc=2760570 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19778446 }}</ref> ===== | ||
* The incidence of Colonic perforation (CP) could be as low as 0.016% of all diagnostic colonoscopy procedures | * The incidence of [[Colonic Perforation|colonic perforation]] (CP) could be as low as 0.016% of all diagnostic colonoscopy procedures and may be seen in up to 5% of therapeutic colonoscopies. | ||
* | * The incidence of CP following flexible [[sigmoidoscopy]] varies from 0.027% to 0.088%. | ||
* Rectal perforation during | * [[Rectal|Rectal perforation]] during [[colonoscopy]] was reported to be around 0.01%. | ||
===== Colonoscopy-related GIT perforation ===== | ===== Colonoscopy-related GIT perforation<ref name="pmid20101766">{{cite journal| author=Lohsiriwat V| title=Colonoscopic perforation: incidence, risk factors, management and outcome. | journal=World J Gastroenterol | year= 2010 | volume= 16 | issue= 4 | pages= 425-30 | pmid=20101766 | doi= | pmc=2811793 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20101766 }}</ref> ===== | ||
* Screening colonoscopy | * Screening colonoscopy perforation rates are 0.01 to 0.1 percent. | ||
* Anastomotic stricture dilation | * Anastomotic stricture dilation perforation rates are 0 to 6 percent. | ||
* Crohn disease stricture dilation | * [[Crohn's disease]] stricture dilation perforation rates are 0 to 18 percent. | ||
* Stent placement | * Stent placement perforation rates are 4 percent. | ||
* Colonic decompression tube placement | * Colonic decompression tube placement perforation rates are 2 percent. | ||
* Colonic endoscopic mucosal resection 0 to 5 percent | * Colonic endoscopic mucosal resection perforation rates are 0 to 5 percent. | ||
* Mortality rates from iatrogenic colonic perforation range from 0 to 0.65 percent. [60] | * [[Mortality rate|Mortality rates]] from iatrogenic [[Colonic Perforation|colonic perforation]] range from 0 to 0.65 percent. [60] | ||
* | * The [[incidence]] of perforation during [[colonoscopy]] increases as the complexity of the procedure increases and is estimated at 1:1000 for therapeutic [[colonoscopy]] and 1:1400 for overall colonoscopies. | ||
* The rectosigmoid area was most commonly perforated followed by the cecum, 53 percent and 24 percent, | * The rectosigmoid area was most commonly perforated followed by the [[cecum]], 53 percent and 24 percent, respectively. [141] | ||
* | * Most perforations were due to blunt injury, 27 percent of perforations occurred with [[polypectomy]], and 18 percent of perforations were produced by thermal injury. | ||
==References== | ==References== | ||
Revision as of 02:12, 29 January 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
Esophageal perforation[1]
- The incidence of iatrogenic esophageal perforation from instrumentation has decreased, but the number of esophageal perforations from external trauma and spontaneous rupture has increased.
- In the period from 1950 to 1954 there was 1 perforation per 20,000 admissions.
- The incidence has now risen to 1 per 8,000 admissions.
Peptic perforation[2]
- There is lower incidence of peptic ulcer complications during the later years.
- Incidence rates varied from 1.5 to 7.8/100000 per year regarding perforated peptic ulcers and from 5.2 to 40.2 regarding peptic ulcer bleeding.
- A perforation rate of 0.11 percent for rigid endoscopy contrasts with a 0.03 percent rate for flexible endoscopy.
- Diagnostic endoscopy with a flexible endoscope perforation rate is 0.03 percent.
- Diagnostic endoscopy with a rigid endoscope perforation rate is 0.11 percent.
- Stricture dilation perforation rate is 0.09 to 2.2 percent.
- Sclerotherapy perforation rate is 1 to 5 percent.
- Pneumatic dilation for achalasia perforation rate is 2 to 6 percent.
- The incidence of perforation related to endoscopy increases with procedural complexity.
- Mortality rates due to perforation are 20 percent.
Colonic perforation[4]
- The incidence of colonic perforation (CP) could be as low as 0.016% of all diagnostic colonoscopy procedures and may be seen in up to 5% of therapeutic colonoscopies.
- The incidence of CP following flexible sigmoidoscopy varies from 0.027% to 0.088%.
- Rectal perforation during colonoscopy was reported to be around 0.01%.
- Screening colonoscopy perforation rates are 0.01 to 0.1 percent.
- Anastomotic stricture dilation perforation rates are 0 to 6 percent.
- Crohn's disease stricture dilation perforation rates are 0 to 18 percent.
- Stent placement perforation rates are 4 percent.
- Colonic decompression tube placement perforation rates are 2 percent.
- Colonic endoscopic mucosal resection perforation rates are 0 to 5 percent.
- Mortality rates from iatrogenic colonic perforation range from 0 to 0.65 percent. [60]
- The incidence of perforation during colonoscopy increases as the complexity of the procedure increases and is estimated at 1:1000 for therapeutic colonoscopy and 1:1400 for overall colonoscopies.
- The rectosigmoid area was most commonly perforated followed by the cecum, 53 percent and 24 percent, respectively. [141]
- Most perforations were due to blunt injury, 27 percent of perforations occurred with polypectomy, and 18 percent of perforations were produced by thermal injury.
References
- ↑ "Practice guidelines in cardiothoracic surgery. American Association for Thoracic Surgery, Society of Thoracic Surgeons, Southern Thoracic Surgical Association, Western Thoracic Surgical Association". Ann Thorac Surg. 56 (5): 1203–13. 1993. PMID 8239832.
- ↑ Hermansson M, Ekedahl A, Ranstam J, Zilling T (2009). "Decreasing incidence of peptic ulcer complications after the introduction of the proton pump inhibitors, a study of the Swedish population from 1974-2002". BMC Gastroenterol. 9: 25. doi:10.1186/1471-230X-9-25. PMC 2679757. PMID 19379513.
- ↑ Bhatia NL, Collins JM, Nguyen CC, Jaroszewski DE, Vikram HR, Charles JC (2008). "Esophageal perforation as a complication of esophagogastroduodenoscopy". J Hosp Med. 3 (3): 256–62. doi:10.1002/jhm.289. PMID 18570335.
- ↑ Lohsiriwat V, Sujarittanakarn S, Akaraviputh T, Lertakyamanee N, Lohsiriwat D, Kachinthorn U (2009). "What are the risk factors of colonoscopic perforation?". BMC Gastroenterol. 9: 71. doi:10.1186/1471-230X-9-71. PMC 2760570. PMID 19778446.
- ↑ Lohsiriwat V (2010). "Colonoscopic perforation: incidence, risk factors, management and outcome". World J Gastroenterol. 16 (4): 425–30. PMC 2811793. PMID 20101766.