Gastrointestinal perforation (hole in intestine)

Abdomen | Gastroenterology | Gastrointestinal perforation (hole in intestine) (Disease)


Description

Gastrointestinal perforation is a complete penetration of the wall of the stomach, small intestine or large bowel, resulting in intestinal contents flowing into the abdominal cavity. Perforation of the intestines results in the potential for bacterial contamination of the abdominal cavity (a condition known as peritonitis).

Perforation of the stomach can lead to a chemical peritonitis due to leaked gastric acid. Perforation anywhere along the gastrointestinal tract is a surgical emergency.

Causes and Risk factors

A person with a perforated bowel has a hole in the wall of the stomach, small intestine, or large intestine. The perforated bowel allows food or stool to leak into the abdomen. Causes of perforated bowel include abdominal injury, inflammatory bowel disease, peptic ulcer disease, colorectal cancer, and diverticulitis.

Sudden attack of pain in epigastrium to the right of midline in case of perforation of duodenal ulcer. In case of gastric ulcer the pain is in epigastrium. There is history of burning pain in epigastrium, flatulence and dyspepsia. History of drug intake without sufficient food intake may be present. In case of intestinal perforation pain starts from the site of perforation, visceral, and then spreads all over the abdomen. In any case there is board like rigidity of abdomen, tenderness, and rebound tenderness. After sometime the abdomen becomes silent, heart sounds can be heard all over. Patient stops passing flatus and motion, abdomen is distended.

Diagnosis and Treatment

Blood tests and CT scan are done to determine how serious is the perforation.

Treatment for a perforated bowel requires surgery to repair the hole in the stomach or intestine. Treatment includes: intravenous fluids, intravenous antibiotics, nasogastric tube insertion, hospitalization, and emergent surgical repair. ...