Alimentary System

Stomach, Forestomach - Perforation

Narrative
Comment:
A perforation (Figure 1) is a hole in the stomach. The contents of the stomach have access to the peritoneal cavity and generally incite a marked inflammatory response. Adhesions between the stomach and adjacent organs or the abdominal wall may occur with larger perforations that persist for some time. Perforations are often caused by gavage accident or by large, aggressive ulcers that progress through the submucosa, muscularis, and serosa.
Recommendations:
Perforation of the forestomach should be diagnosed whenever present, but it is not necessary to assign a severity grade. Secondary lesions, such as inflammation, fibrosis, or adhesions, should generally not be diagnosed separately unless they are prominent components of the lesion. If a perforation is secondary to a foreign body, the foreign body should be diagnosed separately.
References:

Bertram TA, Markovits JE, Juliana MM. 1996. Non-proliferative lesions of the alimentary canal in rats GI-1. In Guides for Toxicologic Pathology. STP/ARP/AFIP, Washington, DC, 1-16.

Full Text: https://www.toxpath.org/docs/SSNDC/GINonproliferativeRat.pdf

Betton GR. 1998. The digestive system I: The gastrointestinal tract and exocrine pancreas. In: Target Organ Pathology (Turton J, Hooson J, eds). Taylor and Francis, London, 29-60.

Abstract: http://www.amazon.com/Target-Organ-Pathology-Basic-Text/dp/0748401571

Brown HR, Hardisty JF. 1990. Oral cavity, esophagus and stomach. In: Pathology of the Fischer Rat (Boorman GA, Montgomery CA, MacKenzie WF, eds). Academic Press, San Diego, CA, 9-30.

Abstract: https://www.ncbi.nlm.nih.gov/nlmcatalog/9002563

Leininger JR, Jokinen MP, Dangler CA, Whiteley LO. 1999. Oral cavity, esophagus, and stomach. In: Pathology of the Mouse (Maronpot RR, ed). Cache River Press, St Louis, MO, 29-48.

Abstract: http://www.cacheriverpress.com/books/pathmouse.htm

Puurunen J, Huttunen P, Hirvonen H. 1980. Is ethanol-induced damage of the gastric mucosa a hyperosmotic effect? Comparative studies on the effects of ethanol, some other hyperosmotic solutions, and acetyl-salicylic acid on rat gastric mucosa. Acta Pharmacol Toxicol (Copenh) 47:321-327.

Abstract: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0773.1980.tb01567.x/abstract
  • Image of perforation in the forestomach from a male F344/N rat in a chronic study

    Stomach, Forestomach - Perforation in a male F344/N rat from a chronic study. The arrows indicate the edges of the perforation.

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Stomach, Forestomach - Perforation in a male F344/N rat from a chronic study. The arrows indicate the edges of the perforation.
Stomach, Forestomach - Perforation in a male F344/N rat from a chronic study. The arrows indicate the edges of the perforation.

Authors:

Linda H. Kooistra, DVM, PhD, DACVP
Pathologist
Charles River Laboratories, Inc.
Research Triangle Park, NC

Abraham Nyska, DVM, Diplomate ECVP, Fellow IATP
Expert in Toxicologic Pathology
Visiting Full Professor of Pathology
Sackler School of Medicine, Tel Aviv University Timrat Israel

Reviewers:

Joel R. Leininger, DVM, PhD
Senior Pathologist
MedImmune
Washington, DC

Amy Brix, DVM, PhD, DACVP
Senior Pathologist
Experimental Pathology Laboratories, Inc.
Research Triangle Park, NC