This delayed diagnosis of a cut or nicked bowel can be deadly. If left untreated, contents of the bowel leak out into the patient's abdomen area, leading to sepsis. Sepsis, an abdominal cavity infection, can cause damage to multiple organ systems. This can lead to organ failure and death.
A bowel perforation should be treated as a medical emergency because the bowel contents in the abdominal cavity can cause infection called peritonitis, which can lead to sepsis if untreated and can lead to death.
A perforation in your GI tract requires immediate medical care. A hole in your large intestine, also known as a bowel perforation, can cause stool to leak into your abdomen. A hole in your stomach or small intestine can leak food or digestive fluids into your abdomen.
Treatment most often involves emergency surgery to repair the hole. Sometimes, a small part of the intestine must be removed.
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].
On rare occasions, a gastrointestinal perforation may heal on its own and not require surgery. If this occurs, a course of antibiotics may be the only treatment. If a person has sepsis, they will require intravenous antibiotics as soon as possible.
The time of operation varied from 45 minutes to 92 minutes.
Recovery for bowel surgery
It can take weeks to recover after bowel surgery. Don't lift anything heavy or do any strenuous exercise for at least six weeks – ask your surgeon how long. It's normal to feel tired while you recover and to need to sleep and rest more than usual. It's important to take time to rest.
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.
Identifying bowel perforation
CT is the exam of choice to identify the cause of pain, the site of perforation, and direct surgical management. It is important to consider the different causes of perforation in the gastrointestinal tract.
In short, yes, it is possible to recover from a perforated bowel.
The treatment will depend on the size of the tear. If it is very minor, then a doctor might only prescribe antibiotics and encourage the patient not to eat or drink for a while. Your doctor then watches the perforation to make sure it heals. However, more serious tears will require surgery.
Bowel perforation can occur during surgery without negligence. It is often a risk of most abdominal procedures. However, there are occasions when it is due to medical malpractice.
In adults, ulcerative disease represents the most common etiology of bowel perforation, with duodenal ulcers causing 2- to 3-times the rate of perforation than gastric ulcers do. Perforation secondary to diverticular disease represents up to 15% of cases.
This is a major surgery. You'll need to check into a hospital. On the day of your surgery, you'll get general anesthesia. That means you'll go into an unconscious, sleep-like state so you don't feel anything during surgery.
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.
Possible Complications
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.
The site of perforation is often linked with its cause [4, 8, 10]; therefore, neoplastic, spontaneous, diverticular (in western countries), blunt trauma and ischemic perforations commonly occur on the left side of colon, whereas inflammatory bowel disease, diverticulitis (in eastern countries) and penetrating trauma ...
The inner lining of the intestines is one of the most-often renewed surfaces in the human body, replenishing itself every 2 to 4 weeks. Lining replacement depends on stem cells stored within indentations called crypts, which are densely scattered across the intestine's inner wall.
Administer systemic antibiotics (eg, ampicillin, gentamicin, or metronidazole), making a best estimation regarding the likely organisms. Nasogastric suction is required to empty the stomach and reduce the risk of further vomiting. Urinary catheterization is used to assess urinary flow and fluid replacement.
Chronic constipation can lead to faecal impaction, stercoral ulcer formation and perforation, which can be life threatening with an associated mortality rate of 47%. Faecal impaction can be defined as symptoms of constipation in the presence of an obstructing faecal mass diagnosed on imaging or digital rectal exam.
Generally accepted conservative approach is to rest bowels by stopping oral diet, intravenous antibiotics, and hydration and following up in between 3 and 6 hours [9].
Complications caused by an intestinal perforation can be related to the disease process that caused it or the treatments that are enlisted. Perforation and subsequent leakage of intestinal contents can lead to peritonitis and eventually sepsis if left untreated.