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. Sepsis, which was often called blood poisoning, is a life-threatening emergency that happens when your body’s response to an infection damages vital organs and, often, causes death. 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. 2023. https://www.sepsis.org/sepsisand/perforated-bowel/
Updated Aug. 4, 2023.
My wife, Gail Guglietta died from septic shock in March 2020. She was 54 years old, having just celebrated her birthday the previous December. The sepsis was brought on by a ruptured colon, which was caused by undiagnosed diverticulitis. (Sepsis and Perforated Bowel, Sepsis and Septic Shock) Despite living a healthy lifestyle that included being active, eating and cooking healthy (she was an excellent cook), and exercising regularly, she dealt with digestive system issues her whole life. It caused her to downplay these problems, noting that these problems happened to her grandmothers. With that, she never got the right diagnosis ... Read Full Story
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My name is James. I am a 53 year old male who lives in Minneapolis, MN. On May 10th of 2021 I woke up and was getting ready to go to the clinic I work at when I started experiencing some abdominal discomfort. Within a half hour I was doubled up in the fetal position in the worst pain ever. EMT to the hospital where I was informed I had a perforated bowel w/ fecal peritonitis. (Sepsis and Perforated Bowel) Went into emergency surgery as well as septic shock and barely survived. Woke up with a colostomy bag and was ... Read Full Story
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My Story: (I wrote this for my online, private support group. Thought I’d share here also. Not looking for sympathy just wanted to share. There’s always hope in your life) Flashback July 2014: I didn’t even know what a colostomy was !! I had severe diverticulitis and had numerous episodes where my bowel perforated (unbeknownst to me !!??!!) Although I was informed before the surgery there might be a chance I could end up with a bag, I never imagined I would be the unlucky one it could happen to. Not knowing was probably better in hindsight. I came round ... Read Full Story
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My sepsis story is from over 10 years ago and the reason I’m deciding today to share this is because my life has never been the same since recovering from sepsis! I continue to have extremely brutal health challenges, including two types of cancer, bowel and bladder issues and continuing G.I. issues! Unfortunately, my health challenges since having perforated diverticular in 2014, that led to sepsis, 21 days and the hospital with four days in ICU and them bringing me back once. (Sepsis and Perforated Bowel) When I finally got out of there, I had a wound pump, a PICC ... Read Full Story
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I was having a Crohns episode from last November 2022. In early 2023 I was admitted to hospital with malnutrition. Two weeks after release I was readmitted with a perforated bowel which led to sepsis. (Sepsis and Perforated Bowel) I was placed in an induced coma for about a week then moved to ICU. I have very little memory of this as I was in and out of consciousness and having hallucinations. What happened and what I remember were not the same and some of my “memories” were clearly fantasy and impossible. after a couple of weeks I was moved ... 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.
