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From infection to trauma: What are the unexpected causes behind intestinal perforation?
A perforation, or intestinal rupture, is a hole in the wall of the digestive tract. This digestive tract consists of the hollow digestive organs from the mouth to the anus, and when perforation occurs, the patient may experience symptoms such as severe abdominal pain, nausea and vomiting. The causes behind this condition vary, including trauma, intestinal obstruction, diverticulitis, stomach ulcers, cancer and infection, which require our special attention.
Intestinal perforation may lead to peritonitis and fatal sepsis, with an extremely high risk of mortality, even after treatment, of up to 50%.
Symptoms and signs
The main symptom of intestinal perforation is sudden severe abdominal pain, which is initially limited to the perforated site and then spreads to the entire abdomen. Abdominal pain worsens when the patient moves, and may be accompanied by early symptoms such as nausea, vomiting, and a rapid heart rate. As the disease worsens, patients may develop fever and chills.
During examination, the abdomen will usually become stiff and tender, and if not treated promptly, bowel movements may cease, resulting in a swollen and silent abdomen.
Complications
The consequences of intestinal perforation should not be underestimated. Leakage of intestinal contents can lead to abdominal infection, with subsequent peritonitis and abscess formation that may result in sepsis. Symptoms of this disease include rapid heart rate, rapid breathing, fever and confusion. If it worsens, it may lead to multiple organ failure, such as acute respiratory distress and kidney failure.
Cause Analysis
Intestinal perforation is usually due to full-thickness injury to the intestinal wall, which can be caused by direct mechanical trauma or chronic damage due to various disease states. These include:
- Traumatic or accidental perforation: such as knife wounds, gunshot wounds, or blunt force trauma from a traffic accident.
- Infectious or inflammatory disorders: Such as appendicitis or diverticulitis, and certain infections (such as C. difficile) may cause intestinal perforation.
- Intestinal obstruction: Obstruction of the intestine caused by scar tissue, intestinal twisting or tumors, which may eventually lead to perforation.
- Corrosive damage: such as gastric ulcers penetrating the inner wall and causing abdominal infection.
Diagnosis and treatment
Diagnosis of intestinal perforation usually requires the use of imaging tests, such as X-rays and CT scans. X-rays can quickly show the presence of gas in the abdominal cavity, while CT scans can provide more detailed information. In early examinations, the results of both may be normal, at which time surgical exploration may be the final test.
Once diagnosed, almost all patients with intestinal perforation require surgical intervention, with the goal of removing damaged tissue and closing the hole in the intestine.
Thinking about the future
Even after a series of medical interventions, such as surgery and antibiotics, patients with intestinal perforation remain at high risk of death. This is not just a medical issue, it also involves all aspects of our lifestyle habits, such as diet and medication use. As technology advances, can we find more effective prevention and treatment methods to reduce the occurrence of this dangerous condition and improve patient outcomes?
