You can have a hole in your colon that happens by itself. This spontaneous type of perforation is usually due to a medical condition, such as inflammatory bowel disease (IBD). Perforated bowels also can be caused by a medical procedure that's done in or near your digestive tract.
Bowel perforation results from insult or injury to the mucosa of the bowel wall caused due to a violation of the closed system. Bowel perforation can be secondary to many factors, including inflammation, infection, obstruction, trauma, or invasive procedure.
Often, patients will not know they have a perforated bowel until symptoms are sever. Early signs of sepsis are: Body temperature above 101 F (38.3 C) or below 96.8 F (36 C) Chills.
Intestinal perforation, defined as a loss of continuity of the bowel wall, is a potentially devastating complication that may result from a variety of disease processes. Common causes of perforation include trauma, instrumentation, inflammation, infection, malignancy, ischemia, and obstruction.
However, a rare and unusual life-threatening complication of chronic constipation is stercoral perforation. Stercoral perforation is the reported cause of 3·4% of colonic perforations.
If the hole is in a person's stomach or small intestine, the onset of pain is usually sudden, but if the hole is in the large bowel, the pain may come on gradually. In either case, once the pain starts, it is likely to be constant. The pain may get worse when the person moves or if there is any pressure on the abdomen.
An intestinal perforation is a major life-threatening condition with high morbidity and mortality that requires emergency surgery. Despite improvements in surgical and medical treatments, the overall mortality rate is 30% and the mortality rate of cases that also have diffuse peritonitis is up to 70% [1,2,3,4].
Survival from the time of perforation differed when compared by BMI groups (p-0.013). Patients with a normal BMI (18.5–25.0 kg/m2) had the longest survival time of 68.0 months, compared to underweight (BMI <18.5 kg/m2) and overweight patients (BMI 25.1–30.0 kg/m2), 14.10, and 13.7 months.
Gastrointestinal perforation (GP) occurs when a hole forms all the way through the stomach, large bowel, or small intestine. It can be due to a number of different diseases, including appendicitis and diverticulitis. It can also be the result of trauma, such as a knife wound or gunshot wound.
It is not always possible to prevent a bowel perforation. However, abdominal pain can start a few days before perforation occurs. If you have persistent, unexplained abdominal pain, contact your doctor as soon as possible or seek prompt medical care.
Colonic perforation occurs in 0.03–0.8% of colonoscopies [1, 2] and is the most feared complication with a mortality rate as high as 25% [1]. It may result from mechanical forces against the bowel wall, barotrauma, or as a direct result of therapeutic procedures.
In addition to determining the presence of perforation, CT can also localize the perforation site. The overall accuracy of CT for predicting the site of bowel perforation has been reported to range between 82% and 90% (3, 10, 11).
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.
Q. How is colon perforation treated? A: Contained perforation — where the contents of the colon have not leaked into the abdominal cavity because of the tear — can be treated in most cases with percutaneous drainage and intravenous antibiotics. The tear may repair itself once the infection is cleared up.
The usual length of stay is 5 to 7 days in the hospital. Your doctor may choose to keep you longer if complications arise or if you had a large amount of intestine removed.
One of the most serious complications of colonoscopy is endoscopic perforation of the colon, which has been reported as between 0.03% and 0.7% [1, 2].
Although perforations usually occur during the colonoscopic examination or within 24 h after the procedure[1-3], delayed perforation of the colon and rectum has been reported[38,39].
One may have an increased suspicion of perforated diverticulitis when patients present with an acute abdomen, severe leukocytosis, or hemodynamic instability; however, these findings are not exclusive of perforated diverticulitis. The sigmoid colon is the most common site of perforation with diverticulitis.
Peritonitis, which can occur if the infected or inflamed pouch ruptures, spilling intestinal contents into your abdominal cavity. Peritonitis is a medical emergency and requires immediate care.
Fever above 100.4°F (38°C) that does not go away. Nausea, vomiting, or chills. Sudden belly or back pain that gets worse or is very severe.
Diverticulitis stool characteristics
Color: The stool may be bright red, maroon, or black and tarry, which indicates the presence of blood. Stools may contain more mucus than normal. Odor: The stool odor may be increasingly foul compared to the typical smell.
Diverticulitis is caused by an infection of one or more of the diverticula. It is thought an infection develops when a hard piece of stool or undigested food gets trapped in one of the pouches. This gives bacteria in the stool the chance to multiply and spread, triggering an infection.
Historically, surgery was advised after two attacks of uncomplicated diverticulitis and after one attack in patients younger than 40 years [16].
The most common symptom is sharp, cramp-like pain in your lower abdomen. The pain may come on suddenly and persist for days without letting up. Usually, the pain is on the left side of the lower abdomen.