Learn About Gastrointestinal Perforation

What is the definition of Gastrointestinal Perforation?

Perforation is a hole that develops through the wall of a body organ. This problem may occur in the esophagus, stomach, small intestine, large intestine, rectum, or gallbladder.

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What are the alternative names for Gastrointestinal Perforation?

Intestinal perforation; Perforation of the intestines; Gastric perforation; Esophageal perforation

What are the causes of Gastrointestinal Perforation?

Perforation of an organ can be caused by a variety of factors. These include:

  • Appendicitis
  • Cancer (all types)
  • Crohn disease
  • Diverticulitis
  • Gallbladder disease
  • Peptic ulcer disease
  • Ulcerative colitis
  • Bowel blockage
  • Chemotherapy agents
  • Increased pressure in the esophagus caused by forceful vomiting
  • Ingestion of caustic substances

It may also be caused by surgery in the abdomen or procedures such as colonoscopy or upper endoscopy.

What are the symptoms of Gastrointestinal Perforation?

Perforation of the intestine or other organs causes the contents to leak into the abdomen. This causes a severe infection called peritonitis.

Symptoms may include:

  • Severe abdominal pain
  • Chills
  • Fever
  • Nausea
  • Vomiting
  • Shock
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What are the current treatments for Gastrointestinal Perforation?

Treatment most often involves emergency surgery to repair the hole.

  • Sometimes, a small part of the intestine must be removed. One end of the intestine may be brought out through an opening (stoma) made in the abdominal wall. This is called a colostomy or ileostomy.
  • A drain from the abdomen or other organ may also be needed.

In rare cases, people can be treated with antibiotics alone if the perforation has closed. This can be confirmed by a physical exam, blood tests, CT scan, and x-rays.

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What is the outlook (prognosis) for Gastrointestinal Perforation?

Surgery is successful most of the time. However, the outcome will depend on how severe the perforation is, and for how long it was present before treatment. The presence of other illnesses can also affect how well a person will do after treatment.

What are the possible complications of Gastrointestinal Perforation?

Even with surgery, infection is the most common complication of the condition. Infections can be either inside the abdomen (abdominal abscess or peritonitis), or throughout the whole body. Body-wide infection is called sepsis. Sepsis can be very serious and can lead to death.

When should I contact a medical professional for Gastrointestinal Perforation?

Contact your health care provider if you have:

  • Blood in your stool
  • Changes in bowel habits
  • Fever
  • Nausea
  • Severe abdominal pain
  • Vomiting
  • Call 911 or the local emergency number right away if you or someone else have ingested a caustic substance.

Call the local poison control center emergency number at 1-800-222-1222 if a person has ingested a caustic substance. This hotline number will let you talk to experts in poisoning.

DO NOT wait until the person has symptoms before you call for help.

How do I prevent Gastrointestinal Perforation?

People will often have a few days of pain before the intestinal perforation occurs. If you have pain in the abdomen, see your provider right away. Treatment is much simpler and safer when it is started before the perforation occurs.

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What are the latest Gastrointestinal Perforation Clinical Trials?
Phase IIa Clinical Study to Assess the Safety and Efficacy of CN128 Tablets in the Treatment of Iron Overload in Transfusion Dependent Thalassemia Patients Aged 16 and Above

Design: The study is designed as a single arm and opened phase IIa clinical trial, so as to investigate the safety and efficacy of CN128. A total of 50 eligible subjects are planned to be enrolled, and orally administration of CN128 for 24 weeks or 48 weeks according to the administration plan. The treatment period is from day 0 to 24 weeks, and the extended treatment period was from 25 weeks to 48 weeks....

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Mortality and Morbidity in Emergency Gastrointestinal Surgery: Comparison of Different Incidence of Interventions According to the ICD-9-CM Classification in Relation to the Age Groups

Summary: Gastrointestinal Emergency Surgery: Evaluation of Morbidity and Mortality

What are the Latest Advances for Gastrointestinal Perforation?
Outcome of Santulli enterostomy in patients with immaturity of ganglia: single institutional experience from a case series.
Paclitaxel with or without pazopanib for ovarian cancer relapsing during bevacizumab maintenance therapy: The GINECO randomized phase II TAPAZ study.
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Safety and feasibility of neoadjuvant chemotherapy as a surgical bridge for acute left-sided malignant colorectal obstruction: a retrospective study.
Who are the sources who wrote this article ?

Published Date: May 04, 2022
Published By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Burns WR, Chang AE. Acute abdomen, bowel obstruction, and fistula. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 52.

Landmann A, Bonds M,  Postier R. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 46.

Matthews JB, Turaga K. Surgical peritonitis and other diseases of the peritoneum, mesentery, omentum, and diaphragm. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 39.

Wagner JP, Chen DC, Barie PS, Hiatt JR. Peritonitis and intraabdominal infection. In: Vincent J-L, Abraham E, Moore FA, Kochanek PM, Fink MP, eds. Textbook of Critical Care. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 99.