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The surprising secret of intestinal perforation: Do you know how it causes acute abdominal pain?
Intestinal perforation, also known as intestinal rupture, is a hole in the wall of the digestive tract. The digestive tract consists of the hollow digestive organs from the mouth to the anus. Symptoms of intestinal perforation usually include severe abdominal pain, nausea, and vomiting. In this case, complications may lead to painful inflammation of the lining of the abdominal wall and the development of sepsis.
Intestinal perforation can be caused by a variety of factors, including trauma, intestinal blockage, diverticulitis, stomach ulcers, cancer, or infection.
Early diagnosis is crucial for effective treatment. Generally, CT scanning is considered the preferred diagnostic method, but in some cases, plain radiographs can also visualize free gas caused by perforation. Perforation of any part of the intestine usually requires emergency surgery, usually an exploratory laparotomy, with concurrent administration of intravenous fluids and antibiotics. Depending on the situation, sometimes the hole can be closed, and sometimes the intestine needs to be removed.
Even with maximal treatment efforts, the risk of death may be as high as 50%.
Symptoms and Signs
A perforated intestine can cause acute, severe abdominal pain that radiates throughout the abdomen. The pain usually worsens with movement and is accompanied by early symptoms such as nausea, vomiting, vomiting blood, and increased heart rate. As the disease progresses, people may develop fever or chills. On examination, the patient's abdomen will become rigid and tender.
Over time, the bowels stop moving and the abdomen becomes silent and distended.
Comorbidities
A hole in the intestine can allow intestinal contents to enter the abdominal cavity, which may lead to peritonitis or abscess formation. As bacteria move from the intestines into the abdomen, patients may develop sepsis, a life-threatening response to the infection characterized by increased heart and breathing rates, fever, and confusion.
Causes
Intestinal perforation can occur for a variety of reasons and may include trauma or accidental perforation during a medical procedure. Penetrating trauma, such as a knife or gunshot wound, may puncture the intestine, while blunt trauma, such as a car accident, may suddenly increase pressure in the intestine and cause it to rupture.
Long-term inflammatory bowel diseases, such as appendicitis and diverticulitis, can lead to intestinal perforation.
In addition, intestinal obstruction is also a common cause. Intestinal obstruction prevents the normal movement of intestinal contents, which may prevent blood flow from reaching the intestinal wall, eventually leading to necrosis and perforation. Ingestion of multiple magnets may also lead to intestinal perforation.
Diagnostic Methods
The diagnosis of intestinal perforation relies on imaging examinations. Intestinal perforation can cause gas to leak into the abdominal cavity, and during examination, a chest X-ray may show gas in the armpit. Although X-rays are inexpensive and quick, CT scans are more sensitive and can more accurately establish the diagnosis and explore the underlying cause of intestinal perforation.
Treatment methods
Surgery is almost always required, usually as an open or laparoscopic procedure. The goal of surgery is to remove any dead tissue and close the hole in the intestinal wall. Conservative treatment can be effective in some cases, especially for patients with controlled perforations. Regardless of whether surgery is performed, all patients should receive pain relief and intravenous fluids and antibiotics.
Multiple antibiotics may help, including combinations of piracillin/tazobactam or ciprofloxacin with metronidazole.
Intestinal perforation is a critical medical emergency and early recognition and intervention can significantly reduce complications and mortality. However, as lifestyle and health conditions change, will the incidence of intestinal perforation continue to rise?
