Fact-sheet: Small bowel perforation
Updated on 10/07/2017 at 6:10 AM
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Definition
Perforation of a small bowel structure.
Multiple etiologies, foremost among which are ingested foreign bodies, post-traumatic causes, and small bowel diverticula.
Note that blunt foreign bodies do not travel freely within the lumen but progress by crossing successive loops one after another.
Clinical features
Abdominal pain, guarding, fever, with or without signs of peritoneal irritation.
Possible obstructive syndrome.
Laboratory findings
Inflammatory syndrome
CT
Infiltration of the mesenteric fat, pneumoperitoneum, possible focal wall thickening.
Look for a foreign body (metallic, vegetable), a diverticulum (Meckel's diverticulum in particular).
Traumatic perforations classically occur in two stages, with contusion preceding perforation.
Management
Surgical management.