What are complications of intestinal perforation?

Updated: Jul 24, 2020
  • Author: Samy A Azer, MD, PhD, MPH; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Multiorgan failure and septic shock may develop. Septicemia (bloodstream infection) is defined as proliferation of bacteria in the bloodstream resulting in systemic manifestations such as rigors, fever, hypothermia (in gram-negative septicemia with endotoxemia), leukocytosis or leukopenia (in profound septicemia), tachycardia, and circulatory collapse. Septic shock is associated with a combination of the following:

  • Loss of vasomotor tone
  • Increased capillary permeability
  • Myocardial depression
  • Consumption of WBCs and platelets
  • Dissemination of powerful vasoactive substances, such as histamine, serotonin, and prostaglandins, resulting in capillary permeability
  • Complement activation and damage of capillary endothelium

Gram-negative infections are associated with a much worse prognosis than gram-positive infections, possibly because of associated endotoxemia.

Renal failure and fluid, electrolyte, and pH imbalance may occur.

Gastrointestinal mucosal hemorrhage is usually associated with failure of multiple organ systems and is probably related to a defect in the protective gastric mucosa.

Mechanical obstruction of the intestine is most often caused by postoperative adhesions.

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