The portals of entry for organisms responsible for most infections which dominate medicine in tropical countries (as elsewhere) are the skin, and respiratory and intestinal tracts. A very high proportion of infections of warm climes originates from ingestion of contaminated water and foodstuffs; many resultant diseases therefore fall into the subspecialty tropical gastroenterology.^[1–3]

Most gastroenterological emergencies which occur in a temperate climate also occur in tropical and subtropical countries. However, there are notable differences in prevalence.^[4]Some are probably ethnically related (although elimination of environmental factors is often difficult), but the majority are superimposed upon an underlying communicable (infective) disease; important examples are ileal perforation or haemorrhage resulting from typhoid (enteric) fever, colonic perforation – and far less often haemorrhage – in …