Also known as: Intestinal perforation and Perforation of the intestines
- Abdominal pain - severe
Gastrointestinal perforation is a hole that develops through the entire wall of the stomach, small intestine, large bowel, or gallbladder. This condition is a medical emergency.
Causes, incidence, and risk factors
Gastrointestinal perforation can be caused by a variety of illnesses, including appendicitis, diverticulitis, ulcer disease, gallstones or gallbladder infection, and less commonly, inflammatory bowel disease, including Crohn's disease and ulcerative colitis.
It may also be caused by abdominal surgery.
Perforation of the intestine leads to leakage of intestinal contents into the abdominal cavity. This causes inflammation called peritonitis.
Symptoms may include:
Signs and tests
X-rays of the chest or abdomen may show air in the abdominal cavity (not in the stomach or intestines), suggesting a perforation. CT scan of the abdomen often shows the location of the perforation. The white blood cell (WBC) count is often higher than normal.
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, CT scan, and x-rays.
Surgery is usually successful, but depends on the severity of the perforation and the length of time to treatment.
Calling your health care provider
Call your doctor if you have severe abdominal pain, fever, nausea, vomiting, blood in your stool, or changes in bowel habits.
Prevention depends on the cause. Diseases that may lead to intestinal perforation should be treated appropriately.
Turnage RH, Richardson KA, Li BD, McDonald JC. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. St. Louis, Mo: WB Saunders; 2008:chap 43.
- Review date:
- June 28, 2010
- Reviewed by:
- Jacob L. Heller, MD, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.