Neonatal gastric perforation

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Vomiting. Distended abdomen.

Patient Data

Age: 1 day
Gender: Male
x-ray

Large volume of intraperitoneal free gas. Bowel loops are dilated with no mural or portal venous gas seen. Gas is present in the rectum.

Lungs are clear. Cardiothymic contour is normal. No bony abnormality noted. Nasogastric tube is below the left hemidiaphragm with the tip projecting over the gastric bubble. 

Case Discussion

This patient proceeded to theater, where a gastric perforation was confirmed. The etiology of neonatal gastric perforation is largely unknown. It is a rare disease with a high mortality, especially among premature infants. 

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