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Small intestine
perforation
SWATILEKHADAS
RN, BSN, MSN
ASST. PROFESSOR
Definition
• Small bowel perforation is a
serious condition in which a
hole in the duodenum,
jejunum, or ileum, allows
intestinal contents to leak out
into the abdominal cavity.
• Bacteria from within the
intestine can cause
"peritonitis" or inflammation
within the abdominal cavity .
The patient can
develop sepsis & possibly
die. SWATILEKHA DAS
Cause
• Perforationfroma duodenal
ulcer
• Perforationduring
endoscopy, ERCP
• Infections (tuberculosis)
• Crohn's disease
• Ischemia
• Injury fromradiation
therapy
• Cancer
• Swallowedforeignbodies SWATILEKHA DAS
Clinical manifestations
• Abdominal pain
• Distention
• Tachycardia
• Tenderness to palpation
• Fever
SWATILEKHA DAS
Diagnostic
tests
Upper GI study with water-
soluble contrast
CT scan
Abdominal X-ray
SWATILEKHA DAS
Management
• Surgery
The perforated segment may be closed
primarily with sutures or the segment
may be resected
If the patient is unstable or if florid
peritonitis is present, it may be best to
create an "Ostomy" for weeks while the
intestines are healing.
If perforation occurs during endoscopy
then physician can repair at time of
endoscopy. If it is not possible then
patient should be taken to emergency OT
immediately.
SWATILEKHA DAS
SWATILEKHA DAS
SWATILEKHA DAS
SWATILEKHA DAS
SWATILEKHA DAS
Thank you
SWATILEKHA DAS

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