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Case Reports
. 2008 Mar;8(1):36-9.

Non-traumatic perforation of the small bowel

Hani O Eid  1 , Ashraf F Hefny, Sandhya Joshi, Fikri M Abu-Zidan
Affiliations
Case Reports

Non-traumatic perforation of the small bowel

Hani O Eid et al. Afr Health Sci. 2008 Mar.

Abstract

Background: Non-traumatic perforation of the small bowel is an uncommon serious complication associated with high morbidity and mortality. Diseases that cause small bowel perforation vary in different areas of the world.

Objective: To highlight difficulties in the diagnosis and management of non-traumatic perforation of small bowel.

Material and methods: The medical records of four patients who have presented with non-traumatic perforation of the small bowel and were treated at Al-Ain Hospital during the last 5 years were studied retrospectively.

Results: The presenting symptoms of all patients were similar. Erect chest X-ray has shown free air under diaphragm in 3 patients. Leukocytosis was present in only one patient. HIV was confirmed in one patient. Patients were diagnosed to have typhoid, HIV, hook worms and tuberculosis. Only the HIV patient died while the others were discharged home in a good condition.

Conclusion: Clinical findings of small bowel perforation are usually non specific and diagnosis is usually reached after surgery. The Histopathological examination of the small bowel ulcer were non conclusive in three patients. We have made our management plan according to the clinical findings. Non traumatic perforation in developing countries can be due to typhoid, HIV, tuberculosis and possibly hook worms.

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Figures

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Legend to figure 1
Intra-operative picture of a small bowel perforation caused by typhoid fever. The omentum was bulging the perforation. This finding is common in typhoid perforation.
Legend to figure 2
Legend to figure 2
Photomicrograph shows many cells with classical inclusions of Cytomegalo Virus (arrow). (Haematoxylin & eosin, oil immersion, 10x100).
See this image and copyright information in PMC

References

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