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Gastrointestinal perforation (GP) occurs when a hole forms all the way through the stomach, large bowel, or small intestine. It can be due to a number of different diseases, including appendicitis and diverticulitis. It can also be the result of trauma, such as a knife wound or gunshot wound. A perforation may also occur in the gallbladder. This can have symptoms that are similar to the symptoms of a gastrointestinal perforation.
A hole in your gastrointestinal system or gallbladder can lead to peritonitis. Peritonitis is inflammation of the membrane that lines the abdominal cavity.
It occurs when any of the following enters the abdominal cavity:
GP is a medical emergency that requires immediate medical care. The condition is life-threatening. Chances of recovery improve with early diagnosis and treatment.
This condition is also known as intestinal perforation or perforation of the intestines.
Symptoms of GP may include:
When you’ve had a gastrointestinal perforation and peritonitis occurs, the abdomen feels very tender. Pain often worsens when someone touches or palpates the area or when the patient moves. Pain is generally better when lying still. The abdomen may stick outward farther than normal and feel hard.
In addition to the general symptoms of perforation, symptoms of peritonitis may include:
Illnesses can cause GP, including:
The condition may also be due to:
To diagnose GP, your doctor will likely take X-rays of your chest or abdomen to check for air in the abdominal cavity. They may also perform a CT scan to get a better idea where the perforation might be. They’ll also order lab work to:
In most cases, surgery is necessary to close the hole and treat the condition. The goals of the surgery are to:
In rare cases, your doctor may forgo surgery and prescribe antibiotics alone if the hole closed on its own.
Sometimes, a piece of the intestine will need removal. The removal of a portion of either the small or large intestine may result in a colostomy or ileostomy, which allows intestinal contents to drain or empty into a bag attached to your abdominal wall.
Complications associated with GP include:
Wound failure may occur in some cases. "Wound failure" means the wound can’t or doesn’t heal. Factors that increase the risk of this include:
The success of surgery to repair a perforation depends on the size of the perforation or hole and the length of time before treatment. The chances of recovery improve with early diagnosis and treatment. Factors that can hinder treatment include:
If you experience pain or fever and you’re at risk of having a GP, you should see your doctor. The sooner you see your doctor, the better your outlook will be.
There are many causes of GP. For example, an underlying gastrointestinal disease can increase your risk for perforation. Get to know your medical history and seek information on the current conditions that might increase your risk.
Speak to a doctor if you experience any significant change from your normal state, especially if you have abdominal pain and fever.
Written by: Natalie Phillips
Medically reviewed on: Feb 12, 2016: Graham Rogers, MD
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