GIT (Gastrointestinal Tract) Perforation

GIT Perforation is an emergency condition resulting from the puncture of any of the organs in the digestive system causing the spillage of its contents into the abdominal cavity.

  • Sudden intense pain in the abdominal area, or in the chest, often accompanied by tenderness to touch, is the usual symptom.
  • An x-ray or CT scan helps in diagnosis.
  • Emergency surgery is necessary to prevent a fatal outcome.
  • Complications include peritonitis and septic shock which may eventually lead to death.

When any organ in the digestive tract is perforated, its contents, including the digested or partially digested food and the secretions of the digestive organs, spill into the abdominal cavity (or into the chest if perforation is in the esophagus). The chemical substances and the bacteria present in these contents usually lead to widespread inflammation as well as infection, which may result in death if not treated promptly.

Perforation of the digestive tract can result from various causes such as gastric ulcers, cancers of the esophagus and the intestines, diverticulitis or appendicitis. Swallowing of corrosive substances and foreign bodies also cause perforations. Perforation of the rectum may be caused by objects inserted into the rectum via anus.

Symptoms

The symptoms vary depending on the site of perforation. When organs in the upper part of the digestive system, from esophagus to duodenum (the first section of the small intestine) are punctured, it results in excruciating pain in the chest or the upper part of the abdomen, often radiating to the shoulders. Nausea and vomiting is almost always present. Abdomen is usually hard and stiff, but tenderness to touch, including rebound tenderness, may be present. Sweating and increased heart rate are other symptoms.

Perforations in the last part of the small intestine or in the large intestine may not cause as many symptoms and the pain also may be less severe. Often, some other painful digestive disorder may be present, which may mask the pain due to perforation, causing the condition to go undiagnosed.

Diagnosis and Treatment

X-rays of the abdomen as well as the chest are taken to assess the condition. An air pocket below the diaphragm is a definite sign of leakage of air from the digestive tract, indicating perforation. Occasionally, a CT scan may be necessary for confirmation.

As soon as the perforation of the digestive tract is confirmed, emergency surgery is performed to minimize the damage caused by the spillage. The contents of the stomach are suctioned out through a tube inserted into the stomach via the nose. It also helps to reduce the pressure in the digestive tract. Antibiotic drugs are given intravenously to contain and prevent possible infections. Intravenous administration of fluids and nutrients is also started. During surgery, the perforated area is repaired and a peritoneal wash is also done to clear the spillage in the abdominal cavity.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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