Small bowel perforation

Fifty four patients who presented with small bowel perforation have been reviewed. There was a variety of aetiologies, the two most common being perforation proximal to small bowel obstruction and perforation at the site of non-specific ulceration. In 16 patients the small bowel perforation was part of a more widespread disorder and in 13 this was the first presentation of the condition. Treatment was often delayed and the clinical and radiological findings were frequently not diagnostic of perforation. Postoperative morbidity and mortality were high due to a combination of delay in diagnosis and the disease process underlying the perforation. Early diagnosis and increased awareness of the causes of this condition should lead to a reduction in morbidity and mortality.