Small Bowel Perforations

Abstract

Small bowel perforation is a common cause of secondary peritonitis in the developing countries and seen less often in the West. Typhoid fever is the commonest cause of small bowel perforation followed by tuberculosis in third world countries, whereas in the developed countries, it is mostly due to mesenteric ischemia, trauma, or Crohn’s disease. Other causes include primary and metastatic tumors, worms, diverticular disease, foreign bodies, drugs, and iatrogenic perforations. Unsafe abortion is a major and significant iatrogenic cause of small bowel perforation bearing high mortality in developing countries, and its incidence is increasing. However, most cases go unreported due to its medicolegal implications. Several new causes of small bowel perforations are added to the list in recent years such as enteroscopy, laparoscopy, and drug-induced perforations due to newer anticancer drugs.