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Health Information Center

Colon Perforation

  • Cynthia M. Johnson, MA
Publication Type:


Colon Perforation

(Perforated Colon; Puncture of Colon)


A colon perforation is a puncture, cut, or tear in the wall of the colon (large intestine). This can cause air and intestinal material to leak into the belly.

Normal Colon.

Nucleus factsheet imagehttp://services.epnet.com/getimage.aspx?imageiid=78877887si2000_105433_1_colon.jpgsi2000_105433_1_colon.jpgNULLjpgsi2000_105433_1_colonNULL\\hgfiler1\intellect\images\si2000_105433_1_colon.jpgNULL63NULL2009-08-122614007887_902781Copyright © Nucleus Medical Media, Inc.


A colon perforation may be caused by:

  • Trauma
  • Pressure against a weak spot of the intestine wall
  • Infection or disease breaking down the intestinal wall

Risk Factors

A colon perforation is more common in people who have had a procedure on the colon.

Some health problems can also weaken the colon walls and raise the risk, such as:


A person with a colon perforation may have:

  • Severe belly pain
  • Fever
  • Bloody stool


A perforation may be seen during a procedure. Any problems that happen shortly after it may also be enough to suspect this health problem.

People who have not had a recent procedure will be asked about their symptoms and health history. A physical exam will be done.

Blood tests may be done to look for any signs of infection.

Images may be taken to look for signs of a leak. This may be done with:


Smaller perforations may heal on their own. The doctor can watch for any changes.

Surgery is needed to fix larger perforations and clean any materials that have leaked. More surgery may be also be needed to treat any damage the leaks caused.

An intestinal leak can sometimes cause a severe infection. Antibiotics may be given to treat it.


Colon perforation can be caused by accidents. These are hard to prevent.

It may also be caused by some intestinal disorders. Managing these problems may lower the risk.





  • Acute perforation of the gastrointestinal tract. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/acute-perforation-of-the-gastrointestinal-tract.
  • Colonoscopy. American Gastroenterological Association GI Patient Center website. Available at: http://patient.gastro.org/colonoscopy.
  • de'Angelis, N., Di Saverio, S., et al. 2017 WSES guidelines for the management of iatrogenic colonoscopy perforation. World J Emerg Surg, 2018; 13: 5.
  • Iatrogenic gastrointestinal tract perforation in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/iatrogenic-gastrointestinal-tract-perforation-in-adults.


  • James P. Cornell, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.