Perforation

Definition

Perforation is a full-thickness hole or rupture in the wall of a body organ, usually hollow (GI tract, gallbladder, bladder). It allows contents to spill into adjacent cavities, causing infection and inflammation.

Common Perforations

• Peptic ulcer perforation → peritonitis
• Appendix rupture → peritonitis
• Diverticulum perforation
• Bowel perforation (cancer, trauma, ischemia)
• Tympanic membrane perforation
• Nasal septum perforation

Clinical Features

Sudden severe pain, rigid (board-like) abdomen, rebound tenderness, absent bowel sounds, fever, tachycardia, hypotension. Free air under diaphragm on upright chest/abdominal x-ray.

Nursing Interventions

NPO, IV access (2 large-bore), IV fluids, broad-spectrum antibiotics, NG decompression, prepare for emergent surgery. Monitor for septic shock.

NCLEX Relevance

Rigid abdomen + sudden pain = emergency for perforation with peritonitis.