Gastrointestinal PerforationSymptoms, Doctors, Treatments, Advances & More
Learn About Gastrointestinal Perforation
A 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.
Intestinal perforation; Perforation of the intestines; Gastric perforation; Esophageal 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.
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
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. Patients who are the best candidates for healing without surgery include those with a contained perforation, hemodynamic stability, and absence of diffuse peritonitis. This can be confirmed by a physical exam, blood tests, CT scan, and x-rays.
A perforation from a colonoscopy may sometimes be closed during the procedure thus avoiding the need for surgery.
Surgery Surgical Services MAP2 3301
Matthew Rubino is a General Surgeon practicing medicine in Newark, Delaware. Dr. Rubino is rated as an Advanced provider by MediFind in the treatment of Gastrointestinal Perforation. He is also highly rated in 15 other conditions, according to our data. His clinical expertise encompasses Ogilvie Syndrome, Retroperitoneal Inflammation, Appendicitis, Hernia Surgery, and Colostomy. Dr. Rubino is currently accepting new patients.
Surgery Surgical Services MAP2 3301
Bradley Mudge is a General Surgeon practicing medicine in Newark, Delaware. Dr. Mudge is rated as an Advanced provider by MediFind in the treatment of Gastrointestinal Perforation. He is also highly rated in 19 other conditions, according to our data. His clinical expertise encompasses Ogilvie Syndrome, Retroperitoneal Inflammation, Gallbladder Disease, Colostomy, and Hernia Surgery. Dr. Mudge is board certified in American Board Of Surgery, Surgery (General Surgery). Dr. Mudge is currently accepting new patients.
Texas Health Surgical Specialists
Winston Chan is a General Surgeon and a Colorectal Surgeon practicing medicine in Arlington, Texas. Dr. Chan is rated as an Advanced provider by MediFind in the treatment of Gastrointestinal Perforation. He is also highly rated in 29 other conditions, according to our data. His clinical expertise encompasses Ogilvie Syndrome, Retroperitoneal Inflammation, Gallbladder Disease, Bladder Reconstruction, and Endoscopy. Dr. Chan is currently accepting new patients.
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 or septic shock can also affect how well a person will do after treatment.
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. Bodywide infection is called sepsis. Sepsis can be very serious and can lead to death.
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, or the local poison control center emergency number at 1-800-222-1222 if you or someone else has ingested a caustic substance.
DO NOT wait until the person has symptoms before you call for help.
People will often have a few days of abdominal 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.
Published Date: April 27, 2026
Published By: Todd Eisner, MD, Private practice specializing in Gastroenterology in Boca Raton and Delray Beach, Florida at Gastroenterology Consultants of Boca Raton. Affiliate Assistant Professor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Matthews JB, Turaga K. Surgical peritonitis and other diseases of the peritoneum, mesentery, omentum, and diaphragm. In: Chung RT, Rubin DT, Wilcox CM, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 12th ed. Philadelphia, PA: Elsevier; 2026:chap 37.
Ritter KA, Junak MI, Scarborough JE, Ho VP. The acute abdomen. In: Tyler DS, Hayes-Dixon A, Hines OJ, et al, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 22nd ed. Philadelphia, PA: Elsevier; 2026:chap 85.