Gastrointestinal perforation classification: Difference between revisions
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{{CMG}}; {{AE}} {{MAD}} | {{CMG}}; {{AE}} {{MAD}} | ||
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==Gastrointestinal perforation classification== | ==Gastrointestinal perforation classification== | ||
=== Gastrointestinal perforation can be classified by causes into: === | |||
===== Instrumental: ===== | ===== Instrumental: ===== | ||
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* [[Neoplasm|Neoplasms]] can perforate by direct penetration and [[necrosis]], or by producing obstruction. | * [[Neoplasm|Neoplasms]] can perforate by direct penetration and [[necrosis]], or by producing obstruction. | ||
=== Gastrointestinal perforation can be classified by age into: === | |||
*Adult-type gastrointestinal perforation | *Adult-type gastrointestinal perforation | ||
*Neonatal gastrointestinal perforation: | *Neonatal gastrointestinal perforation: | ||
Revision as of 03:06, 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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Gastrointestinal perforation Microchapters |
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Differentiating gastrointestinal perforation from other diseases |
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Gastrointestinal perforation classification On the Web |
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Risk calculators and risk factors for Gastrointestinal perforation classification |
Overview
Gastrointestinal perforation classification
Gastrointestinal perforation can be classified by causes into:
Instrumental:
- Instrumentation of the gastrointestinal tract includes upper endoscopy, sigmoidoscopy, colonoscopy, stent placement, endoscopic sclerotherapy, nasogastric intubation, esophageal dilation, and surgery.
- 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.
- Immunosuppressed individuals may be at increased risk for dehiscence and deep organ space infection following surgery.
Iatrogenic:
- Crohn’s disease
- Celiac disease
- Graft-vs-host disease
- Infections:
- Viral: Cytomegalovirus
- Bacteria: Salmonella paratyphi, mycobacterium tuberculosis
- Parasites: Ascaris lumbricoides
- Protozoa: Entameba histolytica
- Drugs: NSAIDs and indomethacin
- Enteric-coated potassium chloride
- Monoclonal antibodies: Bevacizumab
- Meckel’s diverticulum
Inflammatory
- Crohn's disease has a propensity to perforate slowly, leading to formation of entero-enteric or enterocutaneous fistula formation.
- Diseases such as typhoid, tuberculosis, or schistosomiasis can perforate the small intestine.
- The perforations usually occur in the ileum at necrotic Peyer's patches.
Medication
- Aspirin, potassium, disease-modifying antirheumatic drugs, and non-steroidal anti-inflammatory drug use has been associated with perforation.
Neoplasm
Gastrointestinal perforation can be classified by age into:
- Adult-type gastrointestinal perforation
- Neonatal gastrointestinal perforation:
- Necrotising enterocolitis
- Spontaneous
- Iatrogenic
- Umbilical catheterization
- Umbilical cord clamping
- Nasogastric tube
- Obstruction
- Ileal atresia
- Gastric volvulus
- Gastroschisis
- Perforated inguinal hernia