what causes a perforated bowel?
Perforation secondary to intestinal ischemia (eg, ischemic colitis) Bowel perforation by intra-abdominal malignancy, lymphoma, or metastatic renal carcinoma - Even benign tumours, such as desmoid tumours (eg, those originating from the fibrous tissues of the mesentery), may cause bowel perforation.
Presence of a predisposing condition - Predisposing conditions include peptic ulcer disease, acute appendicitis, acute diverticulitis, and inflamed Meckel diverticulum. Indeed, acute appendicitis is still one of the common causes of bowel perforation in elderly patients and is associated with relatively poor outcomes.