Bowel perforation occurs when a gap is formed all the way through the small or large intestine. It may develop due to a host of causes, such as, diverticulitis, appendicitis, or piercing injury from a knife. A hole in the gut can lead to peritonitis or inflammation of the membrane which lines the abdominal cavity. This occurs when bile, bacteria, or the acid from the stomach gain entry in to the abdominal cavity.
Bowel perforation is a medical emergency needing instant medical care. Perforation is life threatening. Chance of recovery improves with early diagnosis and prompt treatment.
Cause Of Perforated Bowel
The following are the commonly seen etiological factors for bowel perforation:
- Gallstones or infection of the gall.
- Inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis.
- Inflamed Meckel’s diverticulum.
Bowel perforation may also be caused by:
- Blunt trauma / injury to the stomach such as a car or bicycle accident.
- Penetrative knife injury.
- Abdominal surgery.
- Consuming NSAIDs, aspirin, and steroids (commoner in the elderly).
- Experts also say that the risk of perforation of the bowel increases when the drug bevacizumab is administered for the treatment of cancer. The risk varies depending upon the drug dose and the type of malignancy its being used for.
Symptoms Of Perforated Bowel
Symptoms and manifestations of bowel perforation include:
- Excruciating pain in the abdomen.
- Fever with chills.
- Nausea and vomiting.
When peritonitis develops, the abdomen feels tender. Pain tends to aggravate when the region is touched. The abdomen may protrude out and feels very hard. Clinical features of peritonitis include:
- Passing less urine and stools
- Raised heartbeat
These symptoms are in addition to the symptoms of bowel perforation mentioned above.
Perforated Bowel Diagnosis And Treatment Options
Your health care provider will order a few tests to make an accurate diagnosis and start immediate treatment.
- X-rays of the chest and abdomen to check for air in the abdominal cavity.
- CT scan to ascertain the location of the perforation.
- WBC count; WBC count is higher than usual signifying inflammation and infection.
- The physician will also examine you; it too helps make a diagnosis. Perceptible signs on palpation of the abdomen include a ridged abdomen.
Once your doctor has made his diagnosis and has established the cause of the perforation he will confer with you for the line of treatment to bring about quick healing. By and large, most doctors opt for surgical intervention to manage the case successfully. The success of the surgery depends upon the size of the hole and the duration before treatment.
Chances of recovery improve with early diagnosis and timely treatment. In a maximum of cases, surgery is required to close the hole and manage the condition. Surgery is carried out to fix the anatomical defect; treat the cause of peritonitis and to get rid of any foreign substance in the abdominal cavity which could cause problems, such as feces, food, or bile.