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What Is Gastrointestinal Perforation?

Medically Reviewed by Carol DerSarkissian, MD on May 26, 2021

‌Gastrointestinal perforation is when the gastrointestinal tract loses continuity. This condition can easily develop into serious complications that could result in death. Early detection and treatment are crucial to prevent complications.‌

Loss of continuity means that the bowel develops a hole in its wall. The gastrointestinal (GI) tract starts from your mouth and ends at your rectum. With a hole in your tract, many medical complications may arise, especially if digested food or feces gets through the perforation.

Causes of Gastrointestinal Perforation

‌Gastrointestinal perforation may happen due to many different reasons. The most common ones are trauma and bowel-related medical conditions.

Medical conditions associated with gastrointestinal perforation include the following:‌

‌‌Using some commonly prescribed over-the-counter medications like nonsteroidal anti-inflammatory drugs (aspirin and corticosteroids) may predispose you to gastrointestinal perforation.

The following trauma incidents may cause gastrointestinal perforation:‌

  • Perforation during an abdominal surgery
  • Gunshot or knife wound
  • ‌Appendicitis
  • ‌Swallowing corrosive substances
  • ‌Swallowing foreign objects

Symptoms

‌Gastrointestinal perforation can be hard to notice in the early stages. You may start noticing the most obvious signs gradually. You may experience these symptoms:‌

  • Severe belly pain
  • ‌Vomiting
  • ‌Fever
  • ‌Nausea
  • ‌Chills

When to call your doctor. As mentioned earlier, early detection and treatment are important to manage gastrointestinal perforation. You must keenly observe yourself if you suspect that you have this condition. There are signs you should look out for after noticing your first symptom. Call your doctor if you notice these signs:‌

  • Severe tummy ache
  • Bloody stool
  • Throwing up
  • A change in bowel habits
  • Fever or increase in body temperature
  • Nausea

Diagnosing Gastrointestinal Perforation

‌After you consult your doctor, they will examine you to diagnose your condition. Diagnosing gastrointestinal perforation mainly involves a physical examination and imaging tests.

These tests include the following:‌

  • X-ray. A chest or abdominal x-ray is done to establish the presence of gas in the stomach cavity. A perforation is responsible for letting air into the stomach cavity.
  • CT scan. Abdominal CT scans may help your doctor check where the gastrointestinal perforation is.
  • Endoscopy or colonoscopy. Procedures like upper endoscopy may also help to locate the gastrointestinal perforation.
  • Blood sample. Blood samples are taken to check for indications of infections and blood loss.

Prevention

‌You can prevent gastrointestinal perforation from occurring. In most cases, you will experience pain some days before the perforation of the wall. Ensure that you consult with your doctor after experiencing abdominal pain. 

‌If the condition is detected before perforation, management can be a lot simpler. It is also safer as you can get treatment before the perforation fully occurs.

Complications

‌The most common complication of gastrointestinal perforations is infection. An infection in the gastrointestinal tract is called peritonitis or an abdominal abscess. 

‌The infection could also spread to other parts of the body through the bloodstream causing sepsis. This can cause whole-body infection, which is a serious condition and may lead to death if not managed in time.

Management

‌Gastrointestinal perforation is a serious condition that may require emergency surgery. Early detection and treatment are crucial for reducing its effects on the gastrointestinal system. Late-stage diagnosis could lead to death.‌‌

Management also involves the treatment of any infection caused by the perforation. Your doctor may treat sepsis using fluids and antibiotic medication.

Surgery is effective in repairing the perforation. The success of treatment by surgery depends on the following conditions:‌

  1. The severity of the perforation. The less severe your condition is, the higher the chances of success.
  2. How long the perforation has been there. A gastrointestinal perforation that has existed for a long time may be harder to manage.
  3. Presence of underlying medical conditions. Other underlying conditions like asthma can make the treatment more complicated.

Your doctor may perform a colostomy. This procedure involves emptying the stomach and putting its contents into a bag. This process is also called an ileostomy. ‌

‌The bowel contents are emptied through a hole (stoma) created in your abdomen. This gives more time to the other parts of your gastrointestinal tract to heal. The hole is later repaired through surgery.

After the surgery, the doctor may give you some antibiotics. These will help in managing and preventing infections.

Conclusion

‌Always tell your doctor everything as it happened to help them make an accurate diagnosis and treat your condition. Take every medication as prescribed by your doctor for effective treatment. Try to avoid self-medication when you experience symptoms of gastrointestinal perforation.

Show Sources

‌SOURCES:

‌Hafner, J., Tuma, F., Hoilat, G., Marar, O. StatPearls. StatPearls Publishing, 2021.

Mount Sinai: “Gastrointestinal perforation.”

‌‌PLOS ONE: “Risk of gastrointestinal perforation in patients taking oral fluoroquinolone therapy: An analysis of nationally representative cohort.”

Sepsis Alliance: “Perforated Bowel.”

Medical Clinics of North America: “Gastrointestinal perforation and the acute abdomen.”

University of Florida Health: “Gastrointestinal perforation.”

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