In Africa and other developing countries, acute abdomen is still a major cause of morbidity and mortality. The study reviewed laparotomy cases following bowel related acute abdomen excluding external hernias from January 2010 to December 2016, managed at District Hospital Damaturu North Eastern Nigeria. A total of 176 patients were studied age ranged between 8 months to 60 years with a male to female ratio of 1: 1. The peak age group was 11 to 20 years accounting for 31.25%. Ruptured appendix was found in 40.91% and 2.84% colonic tumour. The procedures done were closure of bowel perforation in 63.16% for typhoid, and 36.84% for trauma. The post operative complications were surgical site infections in 9.66%, enterocutaneos fistula in 1.70%, and residual abscesses in 1.70%, acute renal failure in 0.6%. The mortality recorded was 1.7%, with acute renal failure, diabetic ketoacidosis, and septicemia accounting for 0.6% each. Procedures done were simple closure of bowel perforations were done in 74, and appendectomy in 72 tables 3. Detailed history and thorough physical examination is the main stay for diagnosis, with limited supportive investigations to plan for definitive treatment.
 

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