Multiple spontaneous jejunal and ileal perforations: a diagnostic challenge

Abstract

Spontaneous multiple small bowel perforations are rare. Perforations of jejunum and ileum contribute to around 0.4% of patients presenting with acute abdomen. While the diagnosis of hollow viscus perforation is relatively straight forward, the site of perforation is often made only after laparotomy. The cause of small bowel perforation, in India, is often due to infections – typhoid fever and tuberculosis. In the Western countries, trauma forms the leading cause, followed by closed loop obstructions, malignancy, jejunal diverticula and tumours. Less common causes of small bowel perforations include Crohn’s disease, ischaemia, iatrogenic manipulations, and drugs such as potassium chloride and steroids.