Your GI tract can perforate because of a GI-related condition or disease, or from a trauma. Conditions that may cause a perforation include:

• Diverticulitis
• Ulcerative colitis or Crohn’s disease
• Toxic megacolon
• Strangulated hernia, which can result in poor blood flow to the intestines
• Injury from a medical procedure, such as a colonoscopy or surgery
• Peptic ulcer disease
• Forceful vomiting
• Loss of blood or poor blood flow to the intestine caused by a blockage in the artery

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:

• Knife or gunshot wound
• Severe blow to the abdomen
• Damage caused by swallowed foreign objects
• Damage caused by swallowing a corrosive (caustic) substance
• Appendicitis

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:

• Severe stomach pain
• Chills
• Fever
• Nausea
• Vomiting

A perforation anywhere in the GI tract is a medical emergency. The emergency medicine 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.

Celebrities like actor Patty Duke and Brazilian soccer player Socrates both died of sepsis. Duke had a perforated colon and Socrates an intestinal infection. Learn about more celebrities who had sepsis here.