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Last Updated: May 05, 2020
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Gastrointestinal Perforation - What You Need To Know?

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Dr. Manish JoshiGastroenterologist • 24 Years Exp.Fellowship In Colorectal Surgery, DNB - Surgical Gastroenterology, Fellowship In Minimal Access Surgery, Fellowship In HPB Surgery, Membership of the Royal College of Surgeons (MRCS), MS - General Surgery, MBBS
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When a hole develops in the wall of the gallbladder, rectum, large bowel, small intestine, stomach or oesophagus, it is called gastrointestinal perforation. It is a medical emergency that needs urgent medical attention.

Symptoms of gastrointestinal perforation (GP) usually include

  1. Serious stomach pain
  2. Chills
  3. Fever
  4. Nausea
  5. Vomiting

Peritonitis (abdominal cavity lining inflammation) can also accompany the abovementioned condition. So in addition to the above symptoms, you may also experience peritonitis symptoms such as:

  1. Fatigue
  2. Passing less gas, urine or stools
  3. Breathing difficulties
  4. Fast heartbeats
  5. Dizziness

Certain diseases can cause Gastro-intestinal perforation, such as:

  1. Appendicitis
  2. Diverticulitis (A type of digestive disorder)
  3. Stomach ulcer
  4. Gallstones
  5. Gallbladder infection
  6. Inflammatory bowel diseases (inflammation in the small intestine and the colon)
  7. Swollen Meckel’s diverticulum (abnormal bulging of the small intestine at birth)
  8. Gastrointestinal tract cancer

Besides diseases, the following conditions can also lead to Gastro-intestinal perforation:

  1. Blunt abdominal trauma
  2. Gunshot or knife wound to the abdomen
  3. Abdominal surgery
  4. Stomach ulcers caused by excessive consumption of steroids, anti-inflammatory drugs and aspirin
  5. Ingestion of caustic substances or foreign objects

Other than these, drinking alcohol, smoking and bowel injuries (caused by colonoscopy or endoscopy) can lead to GP as well.

Treatment options available
This condition is mostly treated with surgery. The goal of the surgery is to repair the anatomical problem and cause of peritonitis, along with removal of any foreign object in the abdominal socket, such as food, faeces and bile. However, if your doctor deems surgery unnecessary (in instances where the hole closes voluntarily) you will be only given antibiotics.
In some cases, a section of the intestine might need to be removed. An ileostomy or colostomy is performed where a portion of the large or small intestine is removed, which grants intestinal contents to empty or drain into a bag implanted on the wall of your abdomen.

The complications include:

  • Bleeding
  • Sepsis (Critical and fatal bacterial infection)
  • Belly ulcers
  • Wound infection
  • Bowel infarction (impaired supply of blood to the bowels)
  • 6. Permanent colostomy or ileostomy

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