Gastrointestinal perforation (GP) occurs when a hole forms all the way through the stomach, large bowel, or small intestine. It might be caused by a number of different diseases, including appendicitis, diverticulitis, or by trauma from a knife wound. A perforation may also occur in the gallbladder. The contents of these organs are then able to spill over into the abdominal cavity.
A hole in your gastrointestinal system can lead to peritonitis. Peritonitis is inflammation of the membrane that lines the abdominal cavity. It can occur if bacteria, bile or stomach acid enters the abdominal cavity.
GP is a medical emergency that requires immediate medical care. The condition is life threatening. Chances of recovery improve with an early diagnosis and treatment.
The condition is also called intestinal perforation, or perforation of the intestines.
GP can be caused by illnesses such as:
The condition may also be caused by:
According to the National Center for Biotechnology Information (NCBI), the risk of GP increases when the medication bevacizumab is used during cancer treatment. Risk varies depending on the dose of the drug and the type of tumor the drug is treating. (NCBI).
Rarely, the condition may occur from bowel injuries from an endoscopy or colonoscopy.
Symptoms of GP may include:
When peritonitis occurs, the abdomen feels very tender. Pain often worsens when the area is touched or palpated. The abdomen may stick outward farther than normal and feel hard.
In addition to the general symptoms of perforation, symptoms of peritonitis may include:
To diagnose GP, your healthcare provider will likely:
In most cases, surgery is necessary to close the hole and treat the condition. According to Medscape (MS), the goals of surgery are:
In rare cases, if the hole has closed, your healthcare provider may forgo surgery and prescribe antibiotics alone.
Sometimes, a piece of the intestine will be removed. If this is done, a temporary colostomy is performed to allow stools to drain or empty into a bag that is attached to your abdominal wall.
The success of the surgery depends on the size of the perforation or hole and the length of time before treatment. The chances of recovery improve with an early diagnosis and treatment. Factors that can hinder treatment include:
Complications associated with GP include:
Wound failure, in which the wound is disrupted and prevented from healing, may occur in some cases. Factors that increase this risk include:
There are many causes of GP. An understanding of any underlying gastrointestinal disease that you might have that could increase you risk for perforation might be helpful. Any significant change from your baseline state, especially if you have abdominal pain and fever, should be addressed promptly..