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.

What are the alternative names for Gastrointestinal Perforation?

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

What are the causes for 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 for 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

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.

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 for 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?

Call your health care provider if you have:

  • Blood in your stool
  • Changes in bowel habits
  • Fever
  • Nausea
  • Severe abdominal pain
  • Vomiting
  • Call 911 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.

Digestive system
Digestive system organs

REFERENCES

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.

Squires R, Carter SN, Postier RG. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 45.

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.

  • Condition: Perforation of the Diverticulum of the Appendix during Chemotherapy with Ramucirumab plus Nab-Paclitaxel for Gastric Cancer
  • Journal: Gan to kagaku ryoho. Cancer & chemotherapy
  • Treatment Used: Emergency Surgery
  • Number of Patients: 1
  • Published —
This case report describes a 65-year-old woman diagnosed with acute panperitonitis with a gastrointestinal perforation during chemotherapy with ramucirumab plus nab-paclitaxel.
  • Journal: Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery
  • Published —
Definition of tumor rupture in gastrointestinal stromal tumor.