What is Perforated Bowel?
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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. Those afflicted will also experience extreme abdominal pain which worsens when one moves. Intense vomiting may occur and result in dehydration. These very serious symptoms need emergency treatment, particularly if one has causal factors like Crohn’s Disease or diverticulitis. Those experiencing these symptoms should waste no time in seeing by a doctor.
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.
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50
My mother is 56 years old and one week ago she went to the hospital with stomach pains. She had multiple surgeries but she did not survive. She had diverticulitis that resulted in a perforated bowl. She was such a strong woman, so beautiful. We are all lost without her. She made it through the colon removal surgery, but she did not make it through the second surgery. I don't know what happened, but after the first surgery they said her small intestine had a dead spot and they had to remove some of it.
She was fine going into that surgery and then afterwards she went into a coma. I am so confused right now about how this could have happened. - anon52560
49
In response to 17, did you see a gastroenterologist, or just a primary doctor? I'm wondering because you stated that you had abdominal pain for four months. Your body was telling you something was not right. i am a nurse and had no symptoms and no pain whatsoever until the day my bowel ruptured from a diverticula. I also was a very healthy young women prior to this event. I suffered septic shock and frank peritonitis from a ruptured abscess. I don't remember much while in critical care, just that when I woke up. I had a colostomy. It was part of me for six months and I had an ileostomy for six weeks due to having an unqualified surgeon. I hope you're doing well. Butterfly 34 - anon51829
48
I had a 30 year old friend who went in to have a hysterectomy due to heavy periods etc. She stayed in hospital for five days to recover. she left on a Saturday and returned the next day in a lot of pain. Within a week all her organs had shut down because they must have nicked a small hole in her bowl and it slowly poisoned her and she later died from this. - anon51629
47
I had a bowel perforation in late October, 2008. I was at work and had no symptoms until I went to the ER due to severe lower quadrant pain. I was admitted and had emergency surgery that same night.
Unfortunately, I had a general surgeon. I was sent home two days post op. On the third day I went into septic shock and survived it. I had a colostomy then had three more bowel perforations. I got a second opinion on the fourth bowel perforation. A wonderful colorectal surgeon, Tam Le, saved my life after eight surgeries to fix all the damage. I am glad to say no more colostomy. it has been five months. this can happen to anyone so be aware of your body and if you need to have surgery, make sure the doctor is qualified. Butterfly 34 - anon51533
46
My mother died of sepsis from a perforated bowel. She had suffered from cancer for over five years. Breast and then bone cancer. She had taken a lot of pain medication. She was a strong woman and we thought she had years yet to enjoy her family. This was all very sudden and she was just too weak to undergo surgery or so the doctors convinced us. We took her to the hospital for fever and pain and 48 hours later she was gone. This is a difficult disease and seems to result from so many different causes. I believe her cancer had weakened her and with all the pain meds, chemo and radiation, I suppose she was just hanging on by a thread. - anon49666
45
I had a hysterectomy back in June and I was told by my doctors that this routine procedure would have me feeling great and like a new woman in a few weeks. I had severe fibroids and surgery was my only option given. Before that I went and had a colonoscopy which required a great deal of blood work and various scans of my pelvic and abdomen. Almost four months later I still look like I am seven months pregnant and hurt in my back all the time. I went to my ob/gyn who casually mentioned that I may have colitis and prescribed a medication called Flagyl and then asked me to schedule an appointment with my gastrics doctor who performed the surgery. I am so upset from how my surgeon who I saw after my surgery only had me to stand and he looked at my scars and told me I was doing fine and the swelling will go down soon. My stool is like baby food green and I eat all the time like I am never full and I do drink a lot of fluids because I am thirsty all the time as well. I don't know what the results are going to be from this but I wanted to write this so that another person does not have to go through this terrible pain for any length of time without seeking help. We know our on bodies and we should listen to them when something is not quite right. - anon48259
44
I have suffered from crohn's disease since 1992. I am now 56 and I have had numerous surgeries and wear a permanent ileostomy pouch, for almost 10 yrs now. I went into hospital 3 weeks ago so my new gastroenterologist could do a camera scope through my ileostomy. while doing the exam the doctor perforated my small intestine, causing me to require immediate emergency surgery as they removed a portion of my small intestine and then resection. I am really upset with the doctor as he knew I had crohn's and multiple previous surgeries. I think he was careless and probably probed too quickly. I am not only in recovery for weeks with substantial discomfort, I am out of work with no sick time. Do I have any recourse or is this just an unfortunate risk given that I have crohn's? any feedback will be appreciated. thanks. - anon47884
43
In reply to anon7694. Yes! I had a routine colonoscopy in August at 10 a.m. By 5 p.m. I was having emergency surgery for a perforated bowel that was caused by the doctor performing the procedure. He tore my colon while removing a polyp.
I'm still returning to the hospital once a day for dressing changes as a result of the surgery. --nbg - auggie
41
i am so glad the chap in write up number 35 has pulled through his very traumatic time. it must have been very scary for his family who love him so much. i hope nobody ever has to go through what his family went through due to the neglect of the doctors at the time! - anon45308
40
My grandma just died a few days ago of apparently a perforated bowel. She went into hospital two weeks ago with a broken hip and although her hip wasn't causing her pain anymore she never got to use it, as she started getting stomach pains because of a blockage in her bowel. she had x rays and tests, and about five enemas over a few days. the blockage had apparently disappeared then the following day it was back (even though she hadn't eaten anything). next thing i know, is a week later her potassium levels were low so she was moved to high dependency ward, where her bowel perforated (doctor said there was not a chance they would be able to operate) so we just had to wait, and 12 hours later she was dead. Now my question is: could it have been the blockage that caused this, and how can a bowel get re-blocked without anything going into her body? She was nil by mouth for about a week! Surely x rays and tests should have picked something up?! - anon44940
39
my son was riding his bike and fell. as he fell the handle bars punched him in the stomach and he had severe pain. i took him to the er and emergency surgery was done within two hours. luckily he doesn't need a bag on the side but he has been vomiting and I'm now waiting on the x-rays to make sure no infection has set in. i hate when any of my boys are sick. i pray he is okay. this is nerve wracking. i don't want any of my kids to ride a bike again. this is a scary thing. the docs said you could die from the infection but after reading the other stories I'm really scared to get the x-ray report. well it's off the the hospital again. hope everyone on here is doing well and be blessed. - anon44232
38
My mother-in-law had her operation, during which a perforated bowel was found to be the cause of her "hip" pain and green bile vomiting. The surgeon gave her a "wash through" (his words)and sewed her up again. Since then she has been on a morphine pump and given no sustenance but she is hydrated. She is literally starving to death. The surgeon says she will not recover and cannot possibly be operated on again because of her weak heart.
This is so cruel and we are in despair for her sake. Any thoughts? - anon42251
37
I'm a medical student, almost finished. radiation therapy can cause perforated bowel as well, for webster73.
For all of you who have complaints about your treatment and then went to see another doctor, make this known to the first doctor so that he or she can do better next time and learn from their mistakes. This world needs good doctors but they don't learn everything in med school, so help them along a little bit. It's sad when people die because of a doctor's ignorance or laziness. - anon41800
36
My mother was rushed back to her hospital to surgically fix a urethral stent (right side). 2-3 days later she had radiation to reduce pain from a fractured, and possibly cancerous, right hip. Two days later, the doctors "discovered" a perforated bowel. For certain reasons, surgery is not a viable option, so she is put on a special nutritional IV and pain management drugs in the hope that her body can repair itself before she goes septic. My question is this: The perforated bowel probably was from the surgery earlier in the week. If the perforation had been discovered during that surgery (or avoided), or closer to it, could she have received this non-surgical treatment sooner and would her chances of survival be better?
Thank you for your time. C-
- webster73
35
i suffered this when i was 16 playing football. I got kneed in the stomach and was immediately in pain, when to hospital on the tuesday night, couldn't pee or anything. My hospital was letting me home the following wednesday shockingly even though i hadn't been to the toilet or eaten for a whole week and was being violently sick. I had one last scan on the wednesday morning before i went home only to be rushed into theatre in about 5 hours for an operation!! Bad times. Was in intensive care for about 3 days. all fit and healthy now though. - anon39113
33
the doctor told me i had a herniated hole in my bowels and that no doctor would do surgery on it unless i got a bowel obstruction from it. everything i have researched shows surgery is the best thing.. can't find much info on this so was wondering if anyone had any info?? - anon38250
32
my mother, age 81, had a 5-pound tumor removed along with her ovaries on july 08 20009. on july 15 2009 her bowel perforated. they could not operate because of her weak condition. the surgeon gave her 2 days. today it is july 22 2009 and she is still going although very weak -- an amazing lady. so trust and have faith. there is always hope - anon37857
31
My 75 year old father was rushed from his dialysis treatment and admitted to the local ER at 9:30 AM suffering from severe abdominal pain. The diagnosis was a bowel perforation. They did not do surgery until 3:30 AM the following morning! He had to be "bagged" which was very humiliating for him but they would reconnect him after the severe infection cleared up. Our father rallied until his heart could no longer keep up. He passed July 13th, 2009. Words cannot explain the sorrow and pain it has caused my family. I just wonder if the hospital's waiting had anything to do with my father's death. He was extremely disoriented and couldn't speak very well. They did CAT scans on him and found he didn't have a stroke but I still want to know why the decline in health. We have received no answers.
I am heartbroken and don't know where to turn for answers. He was a wonderful father and also had excellent health coverage. Any comments would be greatly appreciated. - anon37601
30
I am 51 and after vomitting developed severe lower abdominal pain and left groin pain. I took OTC meds and a hot water bottle to relieve the pain believing it to be a ovarian cyst (which I had before). On day 5, I felt slightly feverish and general feeling of not well. I felt like I needed an antibiotic, so went to ER and recieved a diagnosis of a ruptured diverticuli. I was admitted for 4 days, given IV antibiotics and am now home, somewhat stable, but scared. My MD plans to see me in two weeks and plan surgery laproscopically three weeks after that(it I remain stable). Any one have their bowel resected this way? how did you do with it? - anon37059
29
On May 23rd, 2009, I woke up with abdominal pain and fever almost 102. Hubby took me to ER and I was admitted. CT showed diverticulitis. Treated with IV antibiotics. I was NPO (nothing by mouth) and was so thirsty and hungry. Dr allowed me to have clear liquids the next morning and by that afternoon, my abdomen had swollen up and was hard. Fever went up. CT showed ruptured abscess. So, 8 days later, I was discharged on IV antibiotics and low fiber diet. Seven (7) days after that, I again woke up with pain and high fever. Went to different ER at 4am and by 7:30am was *out* of surgery. Had colon resection and colostomy. Dr said peritonitis had set in *again* with another ruptured abscess and if I had waited one more hour I'd have died. I am now almost 4 weeks post-surgery and doing well. Surgery to reconnect everything and remove colostomy should be in early Sept. Abdominal pain, fever and other associated symptoms mentioned here should *not* be ignored! Do not wait! It could mean your life. - anon35057
28
If a perforation occurs in the small bowel during an endoscopy does it require surgery to be repaired? - anon30115
27
hi i'm a cna and since last Thursday my resident has not been able to eat. she has been nauseated for 3 days, then when I returned to work on my shift she was complaining about abdominal pain and she said no one believes me. well I did. I know she hasn't been feeling very well since that Thursday they had someone come in from radiology and take x-rays of her stomach. she was still complaining of abdominal pain and nausea. my nurse told me to get her ready and she is going to the er and they discovered she has a perforated bowel.she was still having bowel movements. what could have caused this? i found out today she is on life support and has a 50-50 chance of living. - anon29406
26
This is for anon5479. I had a hysterectomy and experienced pain and abdominal distension for 6 days in the hospital and the doctor sent me home anyways. I had not had a bowel movement or passed gas, even with the assistance of suppositories and an enema. Two days later I was in the ER with severe poisoning because of a perforated bowel. A different surgeon operated and gave me a colostomy. I almost died.I have yet to go back and have the colostomy reversed, and get on with my life post hysterectomy. Has any other woman experienced this type of horror, and did you receive compensation? - CindyLouWhoo
25
My friend had surgery for Crohn's and is left with what is being referred to a fissures that do not allow her to heal. When her external wound tries to heal over the build up internally breaks through again and this has been going on for six months post surgery with no sign of improvement. It's not really clear what is going on, where are the fistulas coming from and should she be having further surgery to fix this problem?She is being pawned off by her surgeon and the GP is at her wits end as she's really worried about scepticemia. Any advice?? - anon27872
24
pain medications slow perastalsis and inhibit GI secretions which can leading to a blockage of stool. The intestines become inflamed and bacteria produce more gas, this can lead to perforation. If you're having surgery or admitted to the hospital, listen to your nurse! Walk, move, drink fluids, eat increased fiber and take your stool softeners! Your nurse is there to treat your symptoms, so use them! - anon24880
23
Im 25 years old. On new years eve I went to the hospital for intense abdominal pain and vomiting. My doctor did a CT scan which showed air in my abdomen from a perforated colon. I was in surgery until 5 am january 1st. The doctors still have yet to have a reason for my condition. Im recovering well in my parents home in colorado.. But im scared, I want to know why or what, caused this condition so spontaneously. I wasnt involved in any accidents and the doctor says the section of colon removed looked almost like bubblewrap. Reading more I couldnt help but think diverticulitis but it didnt seem there was any time for me to realize the problem before my colon was perforated.. any ideas.. anyone? - anon24103
22
My X (age 66) just died from having a hip replacement followed by a perforated bowel 3 days later. It then leaked and was patched up and then leaked again. What the heck is going on w/these doctors? Couldn't they have done a colostomy or something more than to try to patch up a rather untidy hole in a bowel? I don't know what caused the perforation, the surgery or a weakness, or the result of a coloscopy he had a short time before the hip replacement. He suffered for almost 5 weeks in intensive care, had a ventilator in for four weeks. Since he had a pacemaker, his heart wouldn't give out but his kidneys finally did. You can't replace the father of my sons or erase the pain and suffering we witnessed. This man did not die with dignity or deserve to suffer this way. I wouldn't want my worst enemy to go through this! - anon21946
21
what can cause a hole in the bowel? - tubz
20
My bowel perforated twice in 3 days, I got an ileostomy, then it prolapsed and intercucepted (fell out in to itself) so it was reversed, I am lucky to be here. My Doctor asked me as I lay septic if I believed in prayer - at that moment i believed more than ever. Here I am 6 years later. i have crohns disease. - faithaf3
19
My father who is 87 is presently in hospital with a perforated bowel. The doctors are refusing to operate and are treating him with antibiotics. He is in extreme pain. What is the likelihood of antibiotics curing this condition? - anon18789
18
My husband was 60 when he died he had had a abdoperineal resection 2 years ago for rectal cancer and given the all clear in january. he had a hemicholectomy for a benign tumor he developed abdominal abscesses and sepsis the abscesses kept reoccurring due to poor bowel anasstomosis the bowel contents leaking into his abdomen causing sepsis he couldnt fight and was to frail for surgery he beat cancer to die of septicemia. so sad. i am now a widow with a teenage son left to cope alone - anon18011
17
I'm 21 years old. I myself had a scare just 7 months ago. I was very ill 4 months before and didn't know what was wrong with me. I was was experiencing very bad pain in my abdomen every day for 4 months and about 8 months ago I was rushed to the hospital. They ran all kinds of tests and I had a perforated bowel and it leaked into my stomach and created peritonitis. I was given 1 more day to live. They did emergency surgery that night and fixed everything up. Just to let everyone know that prior to that I was a very healthy girl, no bowel problems or anything. Sickness can strike anyone at any time so please if your experiencing anything that those other people wrote please seek medical attention. - anon17068
16
My mother Died July 5 of a Perforated Bowel after an Gall Bladder Surgery. Does Methotrexate cause perforated bowel? Methotrexate is treatment for RA. - anon15834
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My husband died of a perforated bowel two months ago today. He did suffer with Crohns but there were no warning signs. Even though i don't want to scare anyone, just be very wary when you hear it mentioned. I was blissfully ignorant that it was a life threatening condition, now i am a widow with two small kids. - anon14747
14
Can pain killers cause a perforated bowel?
- anon13412
13
When I was 15 I was taken to the ER by my family after 17 hours of excruciting pain and vomiting. After an Xray the doctor told me I was fine and had the flu, he was going to send me home! The nurse on duty took over and said I needed a CAT scan. From there I needed surgery. Everyone told us my appendix had ruptured. Once the surgeon opened me up he found that it was my small intestines instead. He took out twelve inches of my small intestines along with my appendix because feces had crystallized on my appendix. I am now 19. I had many years of irritable bowel syndrome since then. I am now doing much better and I try to live life as normal as possible. - anon11677
12
I believe taking large doses of pain medication can lead to a perforated bowel. My 82 year old Mom has been on Oxys for a couple of years after major surgery. Her doctor was giving her over 100 of them a month. Jan. 2 my Mom was rushed to the hospital and passed away in less than 1 hour because of a perforated bowel that they didn't think she was strong enough to go through the surgery for. - anon9791
11
is it possible for a perforated bowel to be caused by a surgeon? i'm really young and i have a colostomy bag. My infection did empty out in my stomach and caused me to faint. - anon9674
10
In July of last year I went by ambulance to MCG hospital where I was put in a wheelchair and told 5 people were ahead of me. I was screaming and crying and doubled out. I basically crawled out of the hospital er and was taken to my moms house where I was in more pain that ever had I felt. I had a perforated bowel and lived off of over the counter drugs. The next day I went to another hospital arriving with a bp of 65-41. I am still unable to get proper medical help because of the red tape of medicaid. Has anyone else out there had this many problems? Just curious. - anon8477
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A perforated bowel is a medical emergency, but the chances that a patient will die from the condition really depends on how quickly they are treated. - anon5526
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I just got home yesterday from the hospital after having an hysterectomy. During surgery, my doctor discovered that I had a perforated small intestine, which evidently had not leaked. Another surgeon was called in to fix it before they even continued with my hysterectomy. I am a little freaked out right now as I am 6 days post-op and have not yet had a bowel movement. I was on a morphine pump for 5 days after the surgery and still on pain meds. I am so afraid that I may cause a tear since I am so constipated. They didn't give me anything in the hospital to make this easier. I am drinking lots of water and taking stool softeners, but so far, no luck. I am up at 2:30am walking because of the pain. Any ideas? No jokes please, until you have been through this. - anon5479
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Are the chances high for someone to die from this ..?
because my aunt is in the hospital right now in a coma that doctors made happen by medicine and she's on life support. my mom says she has a 50/50 chance of living, but she doesn't know that much .. - anon4572
6
Are the symptoms of Diverticulus (extreme, where the bowel has perforated) similar to that of Empyema of the Gall Bladder? - jbates
4
I had a colostomy operation for perforated bowel due to pelvic abscess in 1964 then they did a closure of colostomy in 1965.
I have never seen anyone since regarding this and wonder should I have some sort of follow up? - wakeling
3
how long does this take to show signs?
- firepixie09
2
can large doses of tylenol also contribute to this type of problem? - firepixie09
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Written by
Tricia Ellis-Christensen
Last Modified: 15 November 2009
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