Spontaneous small bowel perforation. A rare cause of acute abdomen.

Spontaneous non traumatic small bowel perforation is a rare cause of an acute abdomen. Preoperative diagnosis is especially difficult, since the symptoms are extremely nonspecific. In most cases, the acute perforation is only diagnosed at exploratory laparotomy. We performed a retrospective analysis on spontaneous perforations of small intestine, occurring in 35 patients, which were treated at our department during a 14-year period from 1974 to 1988. The average age on presentation was 57 years. At the time of operation, peritoneal involvement was already well advanced. In 16 (45.7%) patients, the lesion was oversewn and in 19 (54.3%) cases, resection was required. The difference in mortality between these two methods was statistically not significant.