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Perforated Viscous

Perforated Viscous is a topic covered in the 5-Minute Emergency Consult.

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  • Perforation/break in the containing walls of an organ with contents spilling into peritoneal cavity
  • Inflammation/infection
  • Ulceration
  • Shearing/crushing or bursting forces in trauma
  • Obstruction
  • Chemical and/or bacterial peritonitis occurs as result of disruption of gastric or intestinal lining into peritoneal cavity.


  • Peptic ulcer disease:
    • Majority of cases caused by NSAIDS and Helicobacter pylori
  • Esophageal
  • Small bowel:
    • Ischemia, foreign body, neoplasms, inflammatory bowel disease
  • Large bowel:
    • Diverticular disease, foreign body, neoplasms, inflammatory bowel disease
  • Appendicitis
  • Penetrating or blunt trauma
  • Iatrogenic:
    • Endoscopy, colonoscopy
  • Radiation enteritis and proctitis

Pediatric Considerations
  • Trauma is the more common cause of rupture:
    • Neonates with difficult birth/child abuse/motor vehicle accidents and falls
  • Jejunum is the most common site of rupture.

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Rosen, Peter, et al., editors. "Perforated Viscous." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307423/1.3/Perforated_Viscous.
Perforated Viscous. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307423/1.3/Perforated_Viscous. Accessed June 18, 2019.
Perforated Viscous. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307423/1.3/Perforated_Viscous
Perforated Viscous [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 June 18]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307423/1.3/Perforated_Viscous.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Perforated Viscous ID - 307423 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307423/1.3/Perforated_Viscous PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -