A perforated bowel occurs when hole develops in your bowel wall, part of your gastrointestinal (GI) tract. The GI tract runs from your throat to your rectum. Food travels down your esophagus, into your stomach, where it empties into your small intestine, and then into your large intestine, or bowel. If the perforation occurs in your bowel, it may be called a perforated bowel.
If your GI tract is perforated, the contents may spill into your abdomen and cause peritonitis, an infection. Such an infection can lead to sepsis. Sometimes incorrectly called blood poisoning, sepsis is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.
Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and/or amputations.
Your GI tract can perforate because of a GI-related condition or disease, or from a trauma. Conditions that may cause a perforation include:
The most common trauma that causes a perforated bowel occurs during abdominal surgery, when the surgeon may accidentally nick or cut the bowel and not notice it. Occasionally, a rupture or perforation may happen following bowel surgery, because the stitches or staples used to close the bowel come undone.
Other less common causes for a perforation include:
The signs and symptoms of a perforated GI tract come on gradually, getting worse, although they might not be too noticeable at first. They may include:
A perforation anywhere in the GI tract is a medical emergency. The emergency room doctor will order x-rays and perhaps a computed tomography scan (CT scan). Blood tests look for signs of infection and blood loss from the perforation.
Surgery is usually performed to repair a GI perforation, particularly if it is in the bowel. Rarely, the doctor may prefer to take a wait-and-see approach, to see if the hole will repair itself. Meanwhile, the sepsis caused by the infection must be treated quickly with antibiotics and fluids.
In some cases, the surgeon must perform a colostomy or ileostomy. This surgery allows the contents of your intestines to empty into a bag, through a stoma, a hole created in your abdomen. The colostomy or ileostomy may be temporary, allowing the rest of your intestines to heal. You would then go for a second surgery so your surgeon can reattach your intestines, so you no longer need to eliminate your waste through the stoma. In other cases, the surgery is permanent.
In addition to surgery to repair the perforation, you will likely receive intravenous (IV) antibiotics to either prevent an infection from occurring or to treat one that has started.
A GI perforation is a medical emergency and requires quick recognition of the signs and symptoms, and rapid medical response. When this occurs, recovery should be complete.
If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.”
Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.
Suggested Citation: Sepsis Alliance. Sepsis and Perforated Bowel. 2022. https://www.sepsis.org/sepsisand/perforated-bowel/
Updated May 3, 2022.
On November 3, 2020 Maria was taken to the ER with stomach pains. She was diagnosed with a twisted colon they did a arthroscopic surgery to untwist her colon. Then admitted her to the hospital. Then in 24 hours took her back in for surgery again this time they removed a small portion of her colon. She was doing fine in 24 hours she was taken back in for another surgery because of a swollen abdomen. They found another twist and a tear from the previous surgery. (Perforated Bowel, Sepsis and Surgery) Came out of surgery with a ventilator. They ... Read Full Story
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First time 2007, bowel perforation, and two days lying in hospital as new year lack of staff. (Sepsis and Perforated Bowel) Scan two days later, hole in bowel.Emergency surgery and colostomy and woke up days later intensive care: sepsis and would be lucky to survive night. Family called. I did survive but kidneys and organs took bashing. Unwell, PTSD, I was terrified and still constipated. 2014 Ileostomy op and okay at first but off and on infections, dental and upper airways but no one mentioned sepsis. Pain ,nausea and more infections. They found gallstones but said they were fine. My ... Read Full Story
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On September 29, 2019 my day started out with me feeling a little nauseous so I thought I was coming down with something. Later in the day my stomach was cramping like it always does when I have to go number 2. Only I couldn’t go. Then the cramps turned to pain that continued to get worse. Finally I told my husband to take me to the hospital. By the time we got there the pain was so bad I couldn’t talk. I cried and vomited because that was all I could do. The rest was a blur. My husband ... Read Full Story
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In October of 2016 I had a non cancerous ovarian mass removed. In doing so, my doctor clipped my bowel. (Sepsis and Perforated Bowel) I was sewn up, no drains and stayed in the hospital a week before they let me go home. Within two weeks of being home, I couldn’t eat, had no energy, was nauseous, and could not breath if I attempted to lie back. They had me come in right away for a CT. From that point I was given a sedation (during the CT), and sent to emergency surgery. The bowel had been leaking content into ... Read Full Story
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In May 16th 2022, my mom took my father to the hospital as his neck had started bleeding and she could not get it to stop. As he was on blood thinners, she believed that they would stitch him up and they would be on their way home. When they got to the ER, it was discovered that my dad was in renal failure and had extremely low blood pressure. He was admitted to the hospital. His platelets were also very low and it was discovered that he had an infection in his neck. For a month he went back ... Read Full Story
Submit Your StoryView More StoriesA perforated bowel occurs when hole develops in your bowel wall, part of your gastrointestinal (GI) tract. The GI tract runs from your throat to your rectum. Food travels down your esophagus, into your stomach, where it empties into your small intestine, and then into your large intestine, or bowel. If the perforation occurs in your bowel, it may be called a perforated bowel.
