Patty Duke Dies of Complications of “Ruptured Intestine”

Academy Award winning actress Patty Duke has died at the age of 69. The cause of death was sepsis due to a “ruptured intestine.”

Duke won that Academy Award playing the roll of Helen Keller in the 1962, The Miracle Worker. She had previously played the role on Broadway. After her win she starred on a TV sitcom called The Patty Duke Show, in which she played  both “identical twin cousins” Patty and Cathy Lane. Patty Lane was “all-American” while cousin Cathy a “proper Brit.” She went on to play more mature roles such as Neely O’Hara in Valley of the Dolls.

In 1997, she played the role of Annie Sullivan in The Miracle Worker, and in later years had parts in Glee and on the Nickelodeon show Liv and Maddie. She was married to actor John Astin (who played the Gomez  in the original Addams Family) and was mother to Sean Astin (of Hobbit fame), McKenzie Astin and Kevin Pearce.

What is a ruptured intestine?

471px-Gray1040The term “ruptured intestine” is a layman term for what is usually a perforation (hole) in the intestines. The hole can be anywhere in the gastrointestines, including the esophagus, stomach, small intestine, large bowel, rectum, or gallbladder.

Gastrointestinal perforation can be caused by a variety of illnesses. These include:

Perforation of the intestine causes the contents of the intestines to leak into the abdominal cavity, into a space called the peritoneum. The peritoneum is the serous membrane that forms the lining of the abdominal cavity. It covers most of the intra-abdominal organs, and is composed of a layer of mesothelium supported by a thin layer of connective tissue. The peritoneum supports the abdominal organs and serves as a conduit for their blood vessels, lymph vessels, and nerves.  Under normal conditions, the peritoneum is a sterile space.

A hole in the intestine can allow bacteria, bile, stomach acid, partially digested food and stool to enter the abdominal cavity and causes a serious infection called peritonitis.

Symptoms may include:

  • Severe abdominal pain
  • Chills
  • Fever
  • Nausea
  • Vomiting

Intestinal perforation is a medical emergency, and needs to be vigorously treated with antibiotics to prevent bacteria from getting into the bloodstream. This is called bacteremia. If the number of bacteria is small, the body’s immune system can take care of it.  However, if the number is higher or if the organism is more virulent (likely to cause disease), then the patient has sepsis, or septicemia.  Septicemia can begin with spiking fevers, chills, rapid breathing, and rapid heart rate. The person looks very ill.

The symptoms can rapidly progress to shock with fever or decreased body temperature (hypothermia), falling blood pressure, confusion or other changes in mental status, and blood clotting problems. Low blood pressure can lead to organ shut down, such as kidney and liver failure.

Treatment requires hospitalization, often in an intensive care unit.  Fluids and medicines are given by an IV to maintain the blood pressure. Oxygen will be given. Antibiotics are used to treat the infection. Plasma or other blood products may be given to correct any clotting abnormalities.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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