Spontaneous intestinal perforation with oral administration of ibuprofen for PDA was previously reported [ 148], despite the evidence of preserved renal and mesenteric tissue oxygenation [ 149].
According to the results of a retrospective, claims-based study that evaluated 40,841 RA patients treated with biologic agents, methotrexate, oral glucocorticoids, and NSAIDs, GI perforation is an uncommon (0.11 hospitalizations with GI perforation per 100 PY) SAE among RA patients [ 17].
In a case-controlled study that examined 1100 patients admitted to the hospital for upper GI bleeding or ulceration, oral NSAIDs were strongly associated with perforation (odds ratio 4.8, p < 0.001) and bleeding (odds ratio 1.74, p < 0.001) [88].
However, mucosal leishmaniasis (ML) which affects nasopharyngeal and oral mucosal (with ulceration and septum perforation) never heals spontaneously, it is difficult to treat, and recurrence is frequent [ 21, 22].
CT findings in perforation include pneumoperitoneum, abscess or focal collection of air or fluid with phlegmonous changes adjacent to the perforation site and leakage of oral contrast (Fig. 11).
Peri-implant BRONJ currently is considered an additional complication related to oral implants, along with nerve injury, bleeding, sinus perforation, implant ingestion/aspiration, peri-implantitis, and mucositis [6].
The risk of upper gastrointestinal tract bleeding or perforation increases about twofold with use of oral glucocorticoids or low-dose aspirin, and increases around fourfold with use of other NSAIDs [ 103].
We also identified a perforation site that was 14 cm from the oral margin and 35 cm from the anal margin.
Rates of gastrointestinal adverse events and ulcers, perforation, or bleeding have been much higher with oral nonselective NSAIDs and celecoxib than with topical diclofenac formulations.
The demonstration of unequivocal lateral perforations is consistent with water entering the animal via its oral opening and subsequently being expelled along either side of the animal.
Yoneda et al. [ 15] reported that internal resorption may result in perforation of the root surface or fracture of the tooth and granulation tissue that increased after perforation is considered to be the true cause of oral malodor.
