The Diagnostic, Management Experience and Outcomes of Non-Traumatic Gastrointestinal Tract Perforations in Rural African Setting: A Descriptive Review

Background The gastrointestinal tract is vulnerable to perforations across multiple segments, with diverse etiologies. While existing research has largely focused on urban hospitals, data from rural settings remain scarce. Non-traumatic causes predominate, particularly typhic and peptic perforations. This study aims to determine the frequency of gastrointestinal perforations in a rural, hard-to-reach hospital in Cameroon, to describe the local management approaches and address gaps in rural emergency surgical care delivery. Methods and analysis We conducted a retrospective study at Tokombere District Hospital, with data collection via Google Forms. Analyses used Pearson correlation, Chi-square, and logistic regression in SPSS v26 to adjust for confounders. Significance was set at p < 0.05, with results presented in tables and figures. Results A total of 44 patients were included, with a median age of 21.5 years; most were male (68.2%). Abdominal pain was the predominant presenting symptom (46.9%), and abdominal x-ray served as the main diagnostic tool (36.4%). The average delay between symptom onset and definitive surgery was seven days. The ileum emerged as the most frequent site of perforation, and simple repair was the primary treatment modality (76.3%). Postoperatively, the mean time to return of intestinal transit was 2.8 ± 1.3 days, highlighting both the clinical burden and management outcomes in this cohort. Conclusion an important number of gastrointestinal perforations are being managed at the primary health care level, and efforts should be made to optimise and standardise this management.