Doctor insights on: How to prevent bowel perforation
The gastrointestinal tract starts at the mouth, travel down the tunnel (esophagus), which connects to the stomach, which then empties into the duodenum, jejunum, and ileum---the three parts of the small intestine (@25 feet). This empties into the colon or large intestine (about 5 feet), which then becomes the sigmoid colon, rectum and out the anus. So, every morsel eaten ...Read more
See below: A bowel perforation is an emergency, serious condition where the intestines are leaking internally. Usually it is associated with severe abdominal pain, vomiting, fevers. There are many causes of perforation such as stomach ulcer, small bowel injury from scar tissue, perforated appendicitis, perforated diverticulitis, etc. All these are serious and will require emergency surgery. ...Read more
Yes: The bowel is adjacent to the uterus so it is at risk of injury during surgery to remove the uterus. This is especially of concern if there are adhesions or scar tissue due to endometriosis, previous surgery, or cancer. I recommend bowel preps before a davinci or laparoscopic hysterectomy to minimize risks of a bowel perforation and to facilitate repair if it should occur. ...Read more
Hole in the Bowel: Bowel perforation is often a life-threatening emergency that usually requires emergency surgery to treat. Common causes include a perforated ulcer, diverticulitis, or intestinal cancer. The contents from the bowel is very toxic to the body, requiring emergent intervention. The surgical approach is dependent upon one's health, preoperatively evaluation, and preference of the surgeon. ...Read more
Very small: The literature quotes rates of 1 in 3000. I have done over 10, 000 with no perforations. The risk increases with age and previous abdominal surgeries as well as nutritional status. ...Read more
A few painful days: A perforation of the bowel, by any cause, usually causes leakage of intestinal fluid into the abdomen around the intestine. A very severe infection starts rapidly that typically leads to a painful death in only a few days. Operation to repair the perforation and clean out the infection as well as antibiotics are usually needed. ...Read more
Most will be aware: Generally a bowel perforation causes peritonitis and severe symptoms. On occasion a small perforation can become walled off and not cause peritonitis but it still would cause symptoms in most, but not all, cases. Patients on corticosteroid medication can have a "silent" perforation. The very elderly and patients debilitated by other illness may also have "silent" perforations. ...Read more
What are some warning signs of bowel perforation? Especially if it's minor, like a small hole or tear?
Abdominal pain: It all depends whether it is stomach, small bowel or large bowel. Most of them will present with a quite severe abdominal pain, nausea, vomiting, fever in an otherwise healthy patient. Most of these patients will end up in the hospital quickly due to the pain. The symptoms may be much les prominent in an immunocompromised patients. ...Read more
What to do if I'm afraid of losing my natural flora and also of bowel perforation. How likely are these risks?
Usually in days: If a perforation happens, a known complication of laparoscopic surgery, the size of the opening will regulate how much bowel content may leak. Location in small (lq) or large bowel (solid) affects likely leakage. Small holes may quickly seal up and cause no problem. Leaks that are larger will typically cause peritoneal inflammation (peritonitis) and usually be noticed within a few days (2-3). ...Read more
Very uncommon: Any abdominal or pelvic surgery can result in a bowel injury. The risk depends on how complicated the surgery is to perform. The experience of your surgeon is also important. On the rare occasion that the bowel is injured it can usually be repaired with minimal problems. Problems result if your surgeon did not realize the bowel was perforated. ...Read more
Can I take a rectal temp 20 min after giving toddler a suppository if it didn't work? Could that cause bowel perforation?
If there is past family history of 2 deaths from bowel perforation (1 colonoscopy, 1 cdif) could there be increased risk for other family members?
This morning I heard this loud popping sound from left sidebof abdomen. Could it be bowel perforation, a little pain bur that's all.?
Highly unlikely: Bowel perforations are extremely painful and associated with a high fever. A loud pop could be from a subluxed rib or vertebral body on your spine, but not from a bowel perforation. ...Read more
I have recently had a colostomy reversed (had a bowel perforation following stricture from crohns) want to try for baby I am 36 are there risks?
Yes: The greatest risk is that you might not be able to get pregnant and/or carry to term. Some of that depends on the procedure you had and some depends on your underlying disease and activity and meds that you are on for it. That is worth a good discussion with your gastroenterologist and obstetrician. ...Read more
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