What is intestinal perforation, a problem that led Bonnie Tyler to hospitalization

According to Henrique Dametto, digestive system surgeon at Einstein Hospital Israelita, appendicitis is one of the most common causes of this type of condition. The disease occurs when there is inflammation and infection of the appendix, a small structure attached to the beginning of the large intestine.

In general, appendicitis begins after obstruction of the entrance to the appendix, often by a fecalith, the name given to a small accumulation of hardened feces. Without treatment, inflammation can progress, cause tissue distress and lead to perforation.

"It's not that appendicitis leads to intestinal perforation. The appendix is a piece of the intestine and, if it perforates, this is already an intestinal perforation", says Dametto.

When there is a rupture, bacteria and intestinal contents can reach the abdominal cavity, initially causing a local infection. In more serious situations, the inflammatory response can spread throughout the body and cause a drop in pressure, shock, kidney, heart or other organ failure, and eventually death.

Most cases of appendicitis, however, are treated before reaching this stage. Surgery to remove the appendix is ??usually indicated as soon as the diagnosis is confirmed and, in cases without perforation, hospitalization is generally short.

The main warning signs of appendicitis are severe and progressive abdominal pain, which may begin diffusely and then concentrate in the lower right part of the belly, as well as fever, lack of appetite, nausea and vomiting. "If the pain is progressive, associated with malaise and fever, the ideal is to seek care within 12 hours, maximum 24 hours", says the doctor.

Removal of the appendix is indicated mainly when appendicitis is suspected or confirmed. Preventive removal of the organ, although the appendix is ??not considered essential for survival, is not routinely recommended. Although it is a generally safe and low-complexity surgery, the procedure involves risks and should be performed when clinically indicated.

Other possible causes of intestinal perforation, according to Dametto, are diverticulitis, inflammation of small pockets that can form in the wall of the large intestine, and tumors in the organ. Inflammatory bowel diseases, such as colitis, and ischemic colitis, caused by reduced blood flow to part of the intestine, can also lead to the condition.

Perforation can occur because inflammation or infection compromises the intestinal wall or because an obstruction causes excessive distension of the organ. In both cases, there is a risk of feces and bacteria leaking into the abdominal cavity, which can trigger a serious infection and repercussions throughout the body.

Treatment usually requires urgent surgery to correct or remove the perforated part of the intestine. In the most serious cases, ICU support to control infection and possible organ failure.

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