What is a Perforated Colon?

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  • Written By: Mona D. Rigdon
  • Edited By: A. Joseph
  • Last Modified Date: 20 October 2019
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A perforated colon is a disorder of the gastrointestinal tract. Patients with a perforated colon show a complete hole in the colon, which allows the contents of the intestine to flow into the abdominal cavity. Perforation of the colon or other part of the gastrointestinal tract is a medical emergency that often requires surgical repair.

A patient with a perforated colon can present with symptoms such as bowel obstruction, pain with fever or chills, increased white blood cell count, nausea, diarrhea or constipation. Other symptoms include bloody stool, fatigue and jaundice. These symptoms overlap with those of other conditions, so it is important to know the factors for increased risk of developing a tear in the colon wall. History of certain medical problems such as diverticulitis, Crohn’s disease or colon muscle hernia presents a significant increase in the risk of developing the disorder. The risk of developing this problem increases with age.

The causes of a perforated colon are varied. Gall bladder problems or gallstones, appendicitis or recent surgical procedure can cause a hole in the colon. Damage to the colon through injury, infections such as ulcerative colitis and a hernia of the colon muscle can lead to a perforation. Chronic constipation leading to obstruction can also cause a perforation. A perforated colon can cause many other serious medical emergencies, such as a bacterial infection of the abdominal cavity, a condition called peritonitis.


A doctor must diagnose this serious medical condition. Often, a doctor will order several tests to confirm the suspicion that there is colon damage. Some of these tests can include complete blood count (CBC), X-rays with or without contrast, a CAT scan, magnetic resonance imaging (MRI), an ultrasound scan, sigmoidoscopy, colonoscopy or esophagogastroduodenoscopy (EGD). These tests all give a picture of what is going on inside the bloodstream or the body.

Treatment of a perforated colon is often surgical. When surgery is not required, an extensive hospital stay usually is necessary to combat the infection caused by the intestinal contents that seep into the abdominal cavity. Intravenous antibiotics help combat this infection and usually are continued even after a surgical procedure to repair the condition. As many people have colon or other digestive system damage and never show symptoms, it is possible to live with certain instances of colon perforation. Doctors recommend making this determination after testing and discussion with a specialist to determine the extent of any perforation.

It is possible in most cases to prevent this serious medical condition. A diet that is rich in fiber and a healthy lifestyle are keys to preventing risk factors such as constipation and diverticulitis. Regular exercise also is important. In the United States, the number of people suffering from diverticulitis is the highest of all developing nations, with an estimate that more than 50 percent of people more than 50 years old suffer from the condition. According to doctors, lifestyle choice is the leading cause of many problems that lead to colon perforation.


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