Introduction: The ruptured or perforated viscus challenges the surgeons skill as a technician and his knowledge of preoperative, transoperative and postoperative care of the severely ill surgical patient and assessment needed to decrease both the morbidity and mortality of patients significantly. Methodology: This study has been based on the analysis of 40 cases of hollow viscus perforation and each patient was examined thoroughly, after taking a detailed history. Clinical diagnosis of hollow viscus perforation is made based on history and physical examination which will be confirmed by investigations and laparotomy. Results: Out of 40 cases in this study, 16 patients presented with appendicular perforation (40%), duodenal ulcer perforation was in 11 patients (27.5%), typhoid perforation was in 5 patients (12.5%), 2(5%)patients had small bowel gangrene perforation due to stricture and adhesions, one patient had tubercular perforation (2.5%), one patient had malignancy of left colon presented as perforation (2.5%), 3 patients had traumatic perforation each one in duodenum (2.5%), ileum(2.5%) and intraperitoneal rectum(2.5%). Conclusion: Most common site of perforation was appendix followed by duodenum.

Keywords: Appendix; Hollow Viscus; Perforation.