Merck Manual

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Some Causes of Perforation

Some Causes of Perforation

Area of Perforation



Anywhere along the digestive tract


Forceful vomiting

This disorder is called Boerhaave syndrome.

Injury caused by a medical procedure

Injury is typically caused by an esophagoscope, balloon dilator, or bougie (a thin cylinder-shaped instrument).

Swallowing strong corrosive material

Typically, battery acid or lye is swallowed.

Stomach or the first segment of the small intestine (duodenum)

About one third of people have had no previous ulcer symptoms.

Swallowing strong corrosive material

Such material typically damages the stomach rather than the small intestine.

A blockage that cuts off the blood supply to the intestine (strangulating obstruction)

A blockage (obstruction)

Blockage typically results from cancer or impacted stool.

People who are taking prednisone or other drugs that inhibit the immune system (immunosuppressants) are at high risk of developing diverticulitis. However, these people may have few symptoms.

Expansion of the large intestine (toxic megacolon)

Sometimes spontaneous

Injury that occurs during surgical removal of the gallbladder (cholecystectomy) or liver biopsy

Rarely, inflammation of the gallbladder (cholecystitis)

Injury may be to the gallbladder or bile ducts.