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What is Perforated Diverticulitis?

Mary McMahon
Updated Mar 03, 2024
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Perforated diverticulitis is a very serious gastrointestinal condition in which the walls of the intestine have become perforated. This can lead to peritonitis, an inflammation of the peritoneal cavity which can be deadly if it is not treated. Patients with perforated diverticulitis usually require emergency surgery for treatment.

This condition starts with diverticulosis, in which small pouches start to protrude from the walls of the intestine. This is usually a result of age, and many people have diverticula without being aware of it. If the pouches become inflamed and infected, the condition becomes known as diverticulitis, and it is accompanied with symptoms like abdominal pain and tenderness and nausea. At this point, there is a risk that an infected diverticulum could rupture, leading to perforated diverticulitis.

In patients with perforated diverticulitis, one or more of the pouches breaks open and begins to leak pus and other materials into the abdomen. These materials can lead to inflammation and eventual infection. The patient usually experiences extreme pain and tenderness. A fever and altered level of consciousness can develop if the condition is not treated.

Surgical treatment for perforations involves opening the patient up to clean the abdomen and resect the area of the bowel which has been damaged. The perforated area can be cut out and the two ends can be sewn together in an anastomosis. The surgeon can also check for signs of inflammation and infection along other areas of the bowel during the procedure. After surgery, the patient will need to follow special care directions as the bowel heals.

When diverticulitis is identified, it is important to treat it and to monitor the patient for any signs of changes. These preventive efforts can help to reduce the risk that a diverticulum will perforate and cause complications for the patient. Patients who know they have a history of diverticulitis should make physicians aware of this when they seek treatment for gastrointestinal complaints, as this information can be important when the physician is developing a treatment plan for the patient.

Surgery is also available for the treatment of diverticulitis before it becomes perforated diverticulitis and develops into a medical emergency. A surgeon can discuss this option with a patient if the patient is a good candidate, and patients may want to consider this treatment approach because elective surgeries tend to be less dangerous than emergency surgeries. Electing to undergo a surgical procedure allows more time to plan, to screen the patient for health risks, and to control the timing of the surgery.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments

By anon991983 — On Aug 03, 2015

@anon317546. The meds your brother was on were necessary. The heparin was used to prevent blood clots or treat existing ones. Surgery, especially abdominal, carries the risk of getting blood clots. It is important to get moving immediately after surgery to prevent the. I am so sorry for your loss.

By anon962738 — On Jul 25, 2014

I had perforated diverticulitis. I have irritable bowels so I thought that was it starting on a Friday afternoon. Went through Saturday still uncomfortable, but took kids bowling. I came home and went to bed early as I was exhausted. I got up and the pain still there. I had two bowel movements within the hour. In the next 20 minutes, I was barely able to get to my friends car, and by the time I got to the hospital I couldn't tell them my name. They did a CT scan and told me it was diverticulitis.

I still was unable to speak due to the pain. It was unbelievable. I lay there from 8 a.m. to 4 p.m., with nothing for pain. Then, when they did give it to me, they acted as though I was a drug addict. They hospitalized me because my blood pressure kept dropping every 40 minutes. The antibiotics were trying to fight the infection, but it was to no avail.

At 4 a.m., the surgeon came in and said they needed to go and find out what was going on and it was emergency surgery. Come to find out, I had perforated diverticulitis, but after it ruptured, it covered itself so they could not see that it was still draining into my abdomen on the CT scan.

A three hour surgery turned into a six hour surgery. I was in ICU for 13 days with an illioscopy bag, and I almost died three times. I was lucky not to have a bag for life. I fought for my life like I never have before. I had one complication after another, blockage, infection, my incision needed to be reopened and healed from the inside out. The illioscopy was painful and they could not even consider reversal for six weeks.

They had to cut out 2.5ft of my colon and reconnect it because it was diseased. After six weeks, I had the reversal and struggled for an additional six weeks to get back on schedule. I am told that I will not be healed completely for at least a year and the lesions from my incision have attached to other organs which can be painful.

This is nothing to fool around with. If you are in this much pain, please demand another opinion. Because I couldn't speak and wasn’t crying, they acted as though I was tolerating the pain. If they had done something 24 hours prior, I may not have had to go through what I did. Also I was lucky because I am 40 and if I had been older they told me that it would have been much harder to fight for my life. Most have either a bag for life or no life at all with the amount of infection that filled my body. I was very lucky!

By anon343047 — On Jul 26, 2013

I had this at 27 (I’m a male). I suffered through the diverticulitis outbreaks for several years. I mostly ignored the occasional stomach aches and bloody diarrhea and just figured it was due to my poor diet of Chinese buffets and Taco bell, but then one day it perforated and I was so messed up I had to call my parents to come get me and they had to carry me to the car and take me to the emergency room.

I had a temperature of 106 degrees and was in the worst pain I could imagine. I was on a steady IV of strong antibiotics and pain killers for four days, which luckily cleared out the infection so I could have the surgery a couple weeks later and not have to have a colostomy bag. After surgery, I was pooping after two nights and out of the hospital the third day. Overall, it wasn’t too bad considering the seriousness of the condition. The moral of the story: when your stomach feels like somebody is stabbing you, and you’re pooping blood, go to the damn doctor! I will say though, I did enjoy the month off work the doctor recommended. Loafing around the house resting and watching TV while gorked out on painkillers was a good vacation.

By anon317546 — On Feb 02, 2013

My younger brother was diagnosed with acute diverticulitis in January 2011. He was admitted to the hospital that day. After a week of not responding to treatment, he underwent surgery. He had a drainage bag into which the abscess drained. Even after the surgery, he continued to experience the severe abdominal pains and severe diarrhea. He passed away three days later after suffering acute cardiac arrest. His autopsy report stated that he died after suffering a pulmonary embolism. Among his medications at the hospital were flagyl, tylenol, morphine and heparin. Could any of these medications have caused the occlusion in his lungs?

By anon309892 — On Dec 19, 2012

I had perforated diverticulitis. I had all the symptoms for three years. I was going in and out of the ER, had a colonoscopy, endoscopy, ct scans, was not able to eat, stomach pain accompanied with flu, etc. I spent three years trying to figure out what was wrong.

I weigh usually 125, but by the time I ended up in the ER with my perforated intestine, I weighed 90 pounds. The surgery was done and I'm OK now. But the diagnosis took forever so if you are experiencing symptoms, please, please, please ask your doctor if you have this. I was only 21, female and supposedly it was odd for me to get it.

By anon280993 — On Jul 21, 2012

After a sudden bout of moderate to severe lower abdominal cramps that were progressively getting worse, I went to the ER, had a CT scan, and was diagnosed with Perforated Diverticulitis. I was given intravenous antibiotics and fluids for five days, then released with prescriptions for two types of antibiotics, plus pain relievers and stool softeners. I am to follow up with a colonoscopy in three months. The pain is mostly gone after two days out of the hospital, although the antibiotics cause some nausea for me. They said I am younger than the normal diverticulitis patient. I am a 33 year old male.

By anon274974 — On Jun 14, 2012

With only a diagnosis of deverticulosis of the colon at my first colonoscopy nine years ago, I had no symptoms except for a stomach ache at four in the morning. By nine that evening I went in for a CT scan. By midnight I was in surgery. I now have a colostomy bag for the next three months. The doc says they can reverse the procedure. Right out of nowhere.

By anon189614 — On Jun 23, 2011

I recently had a perforated diverticulitum and had four days of fluids and intravenous antibiotics. I am still on antibiotics some two weeks later and have been told I will have a colonoscopy in about two months time.

My symptoms have largely abated but I feel I have had this condition for some years. I do eat a high fiber diet and have done so for some years.

By burcinc — On Apr 24, 2011

I read that diverticulitis is caused by a diet without enough fiber. It's said to be rare in other parts of the world, but really common here in the U.S. and other Western countries because of our eating habits.

I had heard the same thing about colon cancer a couple of years back. Clearly constipation is not good and it can cause serious health conditions. Americans need to eat more fiber. And I don't mean the kind they put in our smoothies or the powdered drinks they sell at the pharmacy. I mean fruits, veggies and beans!

Eat more fiber people!

By turquoise — On Apr 21, 2011

My granddad had infected diverticula. He surprisingly didn't experience too much pain, he had mild pain time to time and also bloating. He actually has a history of stomach ulcers so we thought he was having acidity. When he started to have cramps, we took him to the doctor and he was diagnosed with diverticulitis.

He was given antibiotics to clear up the infection. The doctor said this is enough for most people, but it didn't clear it up for my granddad. Eventually, they had to do a procedure where they drained the diverticula with a tube.

It was not a very pleasant experience for him, but he also knows that it would have been so much worse if it had perforated. We are just happy that it was caught in time before it got worse.

Mary McMahon

Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

Learn more
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