Gastrointestinal perforation

Definition

Gastrointestinal perforation is a hole that passes through the entire wall of the stomach, small intestine or large bowel. This condition is a medical emergency.

Alternative Names

Causes

Gastrointestinal perforation can be caused by a variety of illnesses, including appendicitis, diverticulitis, ulcer disease, Crohn's disease, and less commonly, infections of the bowel, such as infectious colitis.

Perforation of the intestine leads to leakage of intestinal contents into the abdominal cavity. This causes an inflammation called peritonitis

Symptoms

Symptoms may include:

• Severe abdominal pain
• Fever
• Nausea
• Vomiting

Exams and Tests

X-rays of the abdomen may show air in the abdominal cavity, suggesting a perforation. CT scan of the abdomen often shows the location of the perforation. The person's white blood cell (WBC) count is often higher than normal.

Treatment

Treatment usually involves surgery to repair the hole (perforation). Occasionally, a small part of the intestine must be removed. A temporary colostomy or ileostomy may be needed.

In rare cases, antibiotics alone can be used to treat patients whose perforations have closed. This can be confirmed by a physical exam, blood tests, and x-rays.

Outlook (Prognosis)

Surgery is usually successful, but depends on the severity of the perforation and the length of time to treatment.

Possible Complications

Complications include bleeding, infection, and formation of intra-abdominal abscesses.

When to Contact a Medical Professional

Call your doctor if you have severe abdominal pain, fever, nausea, vomiting, or severe changes in bowel habits.

Prevention

Depending on the cause, perforation can be prevented by preventing any underlying disease that may lead to intestinal perforation. Ulcer disease should be treated with appropriate medicines. Patients with diverticulitis must follow a high fiber diet.