Dorothy FarrarDarmdurchbruch (Darmperforation)
Intestinal perforation is a serious disease that requires acute treatment, in which the intestinal wall shows an intestinal perforation . If intestinal contents enter the abdominal cavity, this can lead to severe inflammation , which poses a mortal danger to the patient. However, with the right therapy, this disease can be treated well.
What is an intestinal perforation (intestinal perforation)?
An intestinal perforation is a locally limited perforation of the intestine through which the contents of the intestine can enter the abdominal cavity. Although the perforation itself is usually relatively small, the intestinal wall is completely perforated and not only damaged in the event of an intestinal perforation.
Basically, a distinction can be made between a free and a covered intestinal perforation. In the case of a free intestinal perforation, the intestinal contents penetrate unhindered into the surrounding abdominal cavity, while in the case of a covered intestinal perforation, the surrounding organs cover the perforation. As a result, with a covered intestinal perforation, hardly any or no chyme can escape into the abdominal cavity.
causes
Intestinal perforation can have many causes, but they are all associated with a pathological change in the intestinal mucosa or the intestinal wall. An undetected or insufficiently treated inflammation of the intestine often leads to an intestinal perforation.Due to an inflammatory reaction in the intestine, the blood flow to the mucous membrane and the intestinal wall is restricted, which leads to tissue damage that can later lead to a perforation of the intestinal wall. Appendicitis , in which there is inflammation of the appendix, is particularly common . However, perforation can also occur due to trauma, such as blunt trauma to the abdomen. Chronic constipation contributes significantly to the development of an intestinal perforation and is one of the most common causes.
Diseases
When to the doctor?
A perforated bowel does not happen without a medical history. This is to the patient’s advantage, because he is usually already under medical treatment and can be informed of the possibility of a intestinal perforation if there is an increased risk of this. Even a small intestinal perforation is accompanied by severe pain and cannot go unnoticed by the person affected.
Especially if the patient knows that this could happen, they should seek immediate medical attention if they experience sudden, moderate to severe abdominal pain. You shouldn’t wait until the following day to do this, because a suspected intestinal perforation is a case for the emergency room. If the bowel perforation is major, it is best to get an ambulance to collect the person immediately, as surgery will be required anyway.
Since even the smallest intestinal perforation can result in the contents of the intestine escaping unhindered into the abdominal cavity and causing serious subsequent symptoms, medical treatment is essential. At best, the doctor is consulted before an intestinal perforation occurs, so that it doesn’t get that far in the first place. In the case of triggers such as appendicitis or similar diseases, it is usually possible to see a doctor early and initiate treatment that prevents intestinal perforation and enables the underlying disease to be healed without any problems.
symptoms and course
Typical symptoms of an intestinal perforation (intestinal perforation):
Characteristic symptoms of an intestinal perforation (intestinal perforation) are above all pain in the stomach or lower abdomen. This pain usually occurs suddenly and is almost unbearable for the patient due to its intensity. Typically, the pain originates from the perforation site, but radiates to the entire abdominal area. There is also tension in the abdominal wall. The abdomen of those affected feels extremely hard.
As the disease progresses, the patient no longer has a bowel movement and the abdomen is bloated. There is severe nausea and vomiting. If there is a free intestinal perforation in which food residues escape into the abdominal cavity, peritonitis with fever and chills can develop.
Diagnose
In order to diagnose an intestinal perforation, the doctor treating you feels the abdomen. Typically, a defensive tension of the abdominal wall is determined. In addition, the doctor collects an anamnesis. Based on the anamnesis and the physical examination, the doctor can already make a suspected diagnosis in most cases.
Imaging procedures such as ultrasound or X-ray examinations are carried out to secure the preliminary diagnosis. If there is an intestinal perforation, there is air below the diaphragm, which can be made visible by an X-ray examination. If air is actually found around the diaphragm during the examination, the suspected diagnosis is thus confirmed.
complications
Complications of a ruptured bowel include severe and persistent pain in the lower abdomen. These are considered to be particularly intense and usually occur suddenly in a stabbing form. Side effects can also occur when taking pain medication. They include organic complaints and an increased risk of addiction. The breakthrough is often preceded by constipation, so that there is a significant reduction in general well-being some time beforehand and coping with everyday life is clearly impaired. There is a risk that the constipation can become chronic.
At the same time, symptoms such as persistent diarrhea are possible. Fever, weakness and malaise occur and the general performance limit is significantly reduced. bloating, chills and tachycardiaare other complaints that are found in those affected. With the occurrence of an intestinal perforation, there is also a life-threatening condition. In some cases, breakthrough is caused by tumor diseases. In addition to surgery, treatment measures such as chemotherapy or radiation therapy are necessary. These are associated with strong physical as well as emotional side effects. If the intestinal perforation is caused by the use of force, trauma can occur depending on the causal events. These are characterized by the fact that the healing path takes place only slowly, making it very difficult to return to normal everyday life.
treatment and therapy
Intestinal perforation is an acute and serious condition that requires immediate hospital treatment. After the diagnosis of an intestinal perforation, the open area must first be closed as part of an operation. In acute emergencies, surgical intervention comes first; only in the further course of treatment is the underlying disease treated.The aim of the operation is to close the perforation and, in the event of a free perforation of the intestine, to flush the abdominal cavity so that the escaping intestinal contents do not cause inflammation in the abdomen or other organs. After the operation, patients must take antibiotics for some time and be monitored in intensive care. Taking antibiotics is particularly important because a variety of pathogens enter the abdomen through the breakthrough.
The pathogens have to be killed off, otherwise there will be severe inflammation and even life-threatening sepsis with multi-organ failure. This conservative treatment of the intestinal perforation is always carried out in connection with a surgical intervention. Intestinal perforation cannot be treated with medication alone. Further treatment then depends on the individual underlying disease that led to the intestinal perforation.
prevention
It is difficult to prevent intestinal perforation with targeted measures, since the development of this clinical picture is complex and can have a wide variety of causes. Nevertheless, by following a few rules, it is possible to greatly reduce your personal risk of suffering an intestinal perforation.
The central point in prophylaxis is maintaining a healthy intestinal flora. A healthy, high-fiber diet keeps the intestines active and there are no blockages that could damage the intestinal mucosa or the intestinal wall. A healthy intestinal flora prevents pathogens from damaging the intestine.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.