[Multiple perforated, poorly differentiated carcinomas of the small bowel]

The small bowel malignant tumors represent a rare pathology; in their diagnosis an important role is played by the clinical suspicion in front of non-specific symptoms. However, the therapeutic decision must not be delayed by excessive explorations, but it should be permanently adapted to the patient's condition; the operative exploration has the advantage of making an accurate diagnosis. The authors present the case of a patient admitted in emergency with the suspicion of a generalized peritonitis from a perforated peptic ulcer and who was subsequently diagnosed with multiple perforated small bowel malignant tumors. The patient's history offers data that could be interpreted in the context of the intraoperative diagnosis. This is the first reported case of multiple perforated poorly differentiated carcinomas of the small intestines.