Bowel Perforation Treatment in Mumbai by Dr Jiten Chowdhry. What is a bowel perforation or hole in your colon and what are the symptoms? Who is at risk? And how is a perforation treated? Overview Your colon is composed of layers of smooth muscle and mucous membranes. The innermost layer, called the mucosa, is soft and pliant—similar to the tissues in your mouth. Bowel perforations occur when a hole is made in this lining, often as a result of colon surgery or serious bowel disease. A hole in the colon then allows the contents of the colon to leak into the usually sterile contents of your abdominal cavity. Symptoms The symptoms of a bowel perforation can vary and may come on slowly or rapidly depending on the underlying cause. Symptoms may include: Abdominal pain (often severe and diffuse) Severe abdominal cramping Bloating Nausea and vomiting A change in your bowel movements or habits. Rectal bleeding Fever (usually not immediately) Chills Fatigue Risk Factors Scientists have found that a number of factors may increase your risk of developing a bowel perforation. These include both factors involved in surgery or a procedure (iatrogenic causes) and bowel diseases characterized by inflammation. Risk factors may include: Recent or prior abdominal. Recent or prior pelvic surgery. Age greater than 75. History of multiple medical problems. Trauma to the abdomen or pelvis (such as in an automobile accident.) A history of diverticular disease. A history of inflammatory bowel disease. Colon cancer Use of the monoclonal antibody immunotherapy drug ipilimumab. Pelvic adhesions (scar tissue, usually related to previous surgeries.) Female gender (women typically have a more flexible colon, which can lead to accidental perforation during medical procedures, including a colonoscopy.) Diagnostic and surgical procedures involving the digestive tract, abdomen, or pelvis. Risk factors for a perforation during a colonoscopy include being female, older age, a history of diverticular disease, and bowel obstructions.