Perforated viscus may be caused by direct or indirect injury. Irritation to the diaphragm in this case comes from below the chest. The diaphragm is the muscle that allows us to breathe. It is located up under the ribs and separates the chest and abdominal cavity. Any irritation to the diaphragm, even from below it, can cause pain to be felt in the chest.
Risk factors not related to trauma are:
- untreated ulcers,
- prolonged or forceful vomiting,
- swallowing a foreign body,
- cancer,
- appendicitis,
- long-term steroid use,
- infection of the gallbladder,
- gallstones, and
- AIDS.