<Tr> <Th> Prognosis </Th> <Td> Risk of death up to 50% </Td> </Tr> <P> Gastrointestinal perforation, also known as ruptured bowel, is a hole in the wall of part of the gastrointestinal tract . The gastrointestinal tract includes the esophagus, stomach, small intestine, and large intestine . Symptoms include severe abdominal pain and tenderness . When the hole is in the stomach or early part of the small intestine the onset of pain is typically sudden while with a hole in the large intestine onset may be more gradual . The pain is usually constant in nature . Sepsis, with an increased heart rate, increased breathing rate, fever, and confusion may occur . </P> <P> The cause can include trauma such as from a knife wound, eating a sharp object, or a medical procedure such as colonoscopy, bowel obstruction such as from a volvulus, colon cancer, or diverticulitis, stomach ulcers, ischemic bowel, and a number of infections including C. difficile . A hole allows intestinal contents to enter the abdominal cavity . The entry of bacteria results in a condition known as peritonitis or in the formation of an abscess . A hole in the stomach can also lead to a chemical peritonitis due to gastric acid . A CT scan is typically the preferred method of diagnosis; however, free air from a perforation can often be seen on plain X-ray . </P> <P> Perforation anywhere along the gastrointestinal tract typically requires emergency surgery in the form of an exploratory laparotomy . This is usually carried out along with intravenous fluids and antibiotics . A number of different antibiotics may be used such as piperacillin / tazobactam or the combination of ciprofloxacin and metronidazole . Occasionally the hole can be sewn closed while other times a bowel resection is required . Even with maximum treatment the risk of death can be as high as 50% . A hole from a stomach ulcer occurs in about 1 per 10,000 people per year, while one from diverticulitis occurs in about 0.4 per 10,000 people per year . </P>

How can you get a hole in your colon
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