Gastrointestinal perforation can be caused by a variety of illnesses, including appendicitis, diverticulitis, ulcer disease, Crohn's disease, and less commonly, infections of the bowel, such as infectious colitis.

Severe abdominal pain, fevers, nausea, and vomiting can accompany perforation.

X-rays of the abdomen reveal air in the abdominal cavity, suggesting a perforation. CT scan of the abdomen often reveals the location of the perforation. The white blood cell (WBC) count is often elevated.

Treatment usually involves surgery. The patient undergoes general anesthesia, and an incision is made in the abdomen. The abdominal cavity is washed out, and the perforation in the intestine or stomach is repaired.

Occasionally, a temporary colostomy or ileostomy may be required. In rare cases, antibiotic therapy alone can treat perforations. This is only the case in patients who have contained and sealed off the perforation, and are not systemically ill. This is evident from physical exam, laboratory tests, and X-rays.

Depending on the disease process and the length of time since the perforation occured, it can usually be successfully repaired with surgery.

Complications include bleeding, infection, and formation of intra-abdominal abscesses.

Call your physician for any severe abdominal pain, fevers, nausea, vomiting, or severe changes in bowel habits.

Depending on the cause, perforation can be prevented by preventing the primary disease process that leads to intestinal perforation. For ulcer disease, this involves appropriate medications. For diverticulitis, this involves adherence to a high fiber diet.

Consult your physician regarding treatment for diseases that can cause perforation.