Complications may include enterocolitis, megacolon, bowel obstruction and intestinal perforation. Meconium ileus has a significant risk of intestinal perforation. Complications such as abscess formation, fistula formation, and perforation of the colon may require surgery. Surgery is usually indicated if intestinal perforation occurs. Nasal septum perforation and renal thrombotic microangiopathy have been reported. Serious complications include deep vein thrombosis, organ perforation, bleeding, and infection. Straining, chronic constipation, and rectal ulcerations predispose to spontaneous perforation in elderly individuals. Previous history of abscess infection or gut perforation with bacterial translocation may be elicited. Complications may include pseudomembranous colitis, toxic megacolon, perforation of the colon, and sepsis. The risk of persistent tympanic membrane perforation after children have grommets inserted may be low. Complications may include bleeding, perforation, and blockage of the stomach. Endoscopy has no role in the diagnosis of spontaneous esophageal perforation. CT angiography lowers the risk of arterial perforation and catheter site infection. Other causes are biliary surgery, liver biopsy, abdominal trauma, and, rarely, spontaneous perforation. Perforation and bleeding are rare during gastroscopy.