Non traumatic perforations are frequent in Africa South of the Sahara and most often due to salmonellosis. From 50 cases recorded in Dakar, the authors study the main problems raised by diagnosis (specially in non reactive peritonitis requiring iterative controls), surgical tactic and procedure, and intensive care. In 86 p. 100 of the case they report on, the authors performed a suture completed by passive drainage. However, and in spite of the risk of leaking, resection had to be done either immediately or because suture failure. As patients were presented generaly in very bad condition, intensive cares were complex but essential. Death rate ranged between 25 p. 100 and 50 p. 100.

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