Perforated Viscous
Basics
Description
Description
- Surgical emergency with mortality of 20–50%
- 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 occur as result of disruption of gastric or intestinal lining into peritoneal cavity
Etiology
Etiology
- Esophageal
- Peptic ulcer disease:
- Majority of cases caused by NSAIDs and Helicobacter pylori, in addition to steroids and aspirin
- Small bowel:
- Ischemia, foreign body, neoplasms, inflammatory bowel disease
- Large bowel:
- Diverticular disease, foreign body, neoplasms, inflammatory bowel disease, volvulus
- Intestinal ischemia
- Appendicitis
- Penetrating or blunt trauma to lower chest/abdomen
- 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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Citation
Schaider, Jeffrey J., et al., editors. "Perforated Viscous." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307423/all/Perforated_Viscous.
Perforated Viscous. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307423/all/Perforated_Viscous. Accessed January 20, 2025.
Perforated Viscous. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307423/all/Perforated_Viscous
Perforated Viscous [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2025 January 20]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307423/all/Perforated_Viscous.
* Article titles in AMA citation format should be in sentence-case
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T1 - Perforated Viscous
ID - 307423
ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307423/all/Perforated_Viscous
PB - Lippincott Williams & Wilkins
ET - 6
DB - Emergency Central
DP - Unbound Medicine
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