What is Perforated Bowel?
A perforated bowel is a medical emergency in which a hole in the bowel opens to allow its contents to empty into the rest of the abdominal cavity. The result is frequently sepsis or blood infection, which if not treated can cause almost immediate death.
A perforated bowel can occur as the result of traumatic injury, Crohn’s Disease, or diverticulitis.
Symptoms of a perforated bowel include high fever and nausea.
When one is afflicted with Crohn’s Disease or diverticulitis, doctors tend to evaluate him or her more closely because of the higher risk factor for developing a perforated bowel. Crohn’s Disease is associated with inflammation in all parts of the intestines, which can result in intestinal blockage. Treatment goals include controlling pain and swelling, so the patient experiences less pain. This disease is not curable and involves lifelong management.
Intestinal blockage can cause perforated bowel, because the bowel cannot regularly pass waste materials out of the body and becomes overloaded. Therefore, regular evaluation of the patient with Crohn’s Disease to rule out intestinal blockage is a necessary medical step.
Diverticulitis is inflammation of small pouches in the colon, called diverticula, which can become infected. Abdominal pain that continually worsens is the most common symptom. Infection of the diverticula is generally treated with antibiotics, though in some cases it may require surgery to clean the infected pouches. When untreated, blockage of the colon can cause perforated bowel and/or intestines.
Trauma to the abdominal region, either from compression, such as from a seat belt during a serious car accident, or from puncture, such as a stab wound, are probably the easiest signals that perforated bowel may exist. In these instances, when pain is present and severe, patients will undergo an X-ray and a computed tomography (CT) scan to confirm diagnosis.
In virtually all cases, perforated bowel requires surgery to wash out the abdomen. The perforated bowel is then repaired. Occasionally, perforation affects the bowel and other parts of the intestine and may require colostomy, in which part of the large intestine is brought into the wall of the abdomen and waste material is excreted into a bag outside the body. This is generally temporary. After surgery, the patient must take strong doses of antibiotics to rid the body of any leftover infection and to prevent recurring peritonitis, in which the cavities surrounding the abdomen and intestines become infected.
Patients who have had a perforated bowel will need consistent follow-up, and treatment for underlying conditions that may have caused the perforation. In many cases, after initial treatment, patients have no recurrence of perforated bowel. Consulting one’s physician about the possibility of recurrence is advisable.