Bowel perforation: what it is, how it occurs, and the importance of prompt treatment

Posted: 30/08/2022

What is bowel perforation?

The term ‘bowel perforation’ refers to a hole in the wall of the bowel, which can cause the contents of the bowel to leak. The bowel sits within the abdominal cavity (alongside many other internal organs), which means that any leaking can lead to severe infection and inflammation. In some cases, this can be fatal, so prompt and appropriate treatment is very important.

How does bowel perforation occur?

Bowel perforation has a number of causes, from bodily trauma to a variety of diseases. Bodily trauma can include anything from a blunt trauma accident, or wound to the abdomen, to any medical procedure around the bowel. Other causes of bowel perforation include the lodging of a foreign object in the bowel, and severe constipation resulting in bowel impaction.

Diseases that can lead to bowel perforation can include:

• Inflammatory bowel disease (IBD)
• Colon cancer
• Diverticular disease
• Ischemic colitis

Medical procedures causing bowel perforation can include:

• Abdominal surgery
• Enema
• Colonoscopy (including the cleansing and preparation of the bowel before a colonoscopy)

The importance of prompt treatment

If left untreated, bowel perforation can lead to bleeding in the abdomen cavity, and infection, which can lead to sepsis, disability and even death. These consequences vary depending on the severity and circumstances of the perforation, the patient’s general health and their age.

Depending on where the perforation has occurred in the bowel, and the size of the perforation, a colorectal surgeon will usually provide treatment either by surgery, or through an endoscope.

How can we help?

Penningtons Manches Cooper has assisted many clients in investigating clinical negligence claims in relation to bowel perforation. This may be as a result of surgical error, or a failure to diagnose and treat a perforation that has already arisen. We have worked with a client who required emergency surgery, with significant time in the ICU and the insertion of a stoma, due to being incorrectly monitored for constipation, which caused a bowel impaction and subsequent perforation. Another client suffered the misplacement of a suprapubic catheter, which resulted in both a perforated bladder and bowel, while another had his bowel accidentally stitched into the closure wound following a nephrectomy procedure.

If you have any concerns following your treatment for bowel perforation, please do not hesitate to get in touch.

This article was co-written with Jessica Earley, trainee solicitor in the personal injury/clinical negligence team. 

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