Unravelling the unexpected: A rare case of 17 spontaneous intestinal perforations in an infant treated at Mbale Tertiary Hospital, Uganda

Spontaneous intestinal perforations in neonates and infants are rare and pose significant challenges, especially in low-resource settings. We present a unique case of a female infant treated at Mbale Tertiary Hospital, Uganda, with 17 spontaneous intestinal perforations. She presented with acute abdominal distension, peritonitis, and septic shock. Emergency exploratory laparotomy revealed multiple perforations along the small intestine, with no evidence of obstruction, necrotizing enterocolitis, or trauma, confirming the diagnosis. Surgical management involved resecting affected bowel segments and performing primary anastomosis. Postoperative care included infection control, nutritional support, and close monitoring. Despite the tertiary surgical care due to the complexity of the critical condition, the infant succumbed. This case underscores the importance of early recognition, multidisciplinary collaboration, and timely surgical intervention in managing rare pediatric conditions. Documenting such cases enhances understanding of spontaneous intestinal perforations and informs strategies for improving outcomes, particularly in resource-limited settings.