Sites and causes of bowel perforations are:
1. Duodenum: The most common site of perforation in the bowel is duodenum. Duodenal perforation is a complication of untreated chronic duodenal ulcer and administration of NSAIDS The duodenum gets perforated commonly on the anterior surface .
2. Stomach: Either a peptic ulcer or carcinoma of stomach may get perforated. Administration of NSAIDS may contribute to perforations of stomach.
3. Small intestines: Perforation of small intestines is due to typhoid fever and regional enteritis or as a complication of unrelieved intestinal obstructions.
4. Large intestines: The large bowel perforations are mainly due to malignancy, diverticulosis, ulcerative colitis and during medical procedures like colonoscopy, sigmoidoscopy and biopsies.
5. Other appendages: Intestinal appendages like vermiform appendix , Meckels diverticulum or colonic diverticula may get inflamed and get perforated.
6. Other causes: Intestinal obstructions , strangulations may lead to perforations. External penetrating injuries and injuries to intestines during laparoscopic and surgical procedures may cause perforations of intestines.
Clinical features and treatment: Any perforation in the bowel causes peritonitis. The treatment is as for peritonitis.

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