Diagnosis, management, and outcomes of non-traumatic gastrointestinal tract perforations in A rural district hospital in Northern Cameroon: a retrospective observational study

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. This study aims to determine the frequency of non-traumatic gastrointestinal perforations in a rural, hard-to-reach district hospital in Northern Cameroon, to describe the local management approaches and address gaps in rural emergency surgical care delivery. Methods We conducted a retrospective descriptive study of patients who underwent surgery for non-traumatic gastrointestinal tract perforation at Tokombéré District Hospital from January 2021 through January 2023. Categorical variables were compared using Pearson’s Chi-square test or Fisher’s exact test, and continuous variables using the Mann–Whitney U or Kruskal–Wallis test. Significance was set at p < 0.05. Results A total of 44 patients were included, with a median age of 21.5 years (IQR 9-43). Abdominal pain was the predominant presenting symptom (70.5%, 31/44), and abdominal x-ray served as the main diagnostic tool (36.4%, 16/44). The median time interval from symptom onset to definitive surgery was 6 days (IQR 4–10). The small bowel emerged as the most frequent site of perforation (47.6%), and simple repair was the primary treatment modality (76.3%). Postoperative complications occurred in 27 patients (61.4%), and postoperative in-hospital mortality was 4.5% (2/44). Conclusion The rural district hospital setting in Northern Cameroon imposes particular challenges to the diagnosis, management and follow-up of nontraumatic gastrointestinal perforations. Delayed presentation is a common finding, and children and young adults accounted for most cases in this cohort.