Gastrointestinal perforation

Overview
Gastrointestinal perforation is a complete penetration of the wall of the stomach, small intestine or large bowel, resulting in intestinal contents flowing into the abdominal cavity. Perforation of the intestines results in the potential for bacterial contamination of the abdominal cavity (a condition known as peritonitis). Perforation of the stomach can lead to a chemical peritonitis due to leaked gastric acid. Perforation anywhere along the gastrointestinal tract is a surgical emergency.

Causes
Underlying causes include gastric ulcer, appendicitis, gastrointestinal cancer, diverticulitis, trauma, and Ascariasis.

Symptoms
Gastrointestinal perforation results in severe abdominal pain intensified by movement, nausea and vomiting. Later symptoms include fever and or chills.

Diagnosis
On X-rays, free gas may be visible in the abdominal cavity. The perforation can often be visualised using CT. White blood cells are often elevated.

Treatment
Treatment depends on the underlying cause, but surgical intervention is nearly always required.