Spontaneous Intestinal Perforation in Neonates

BACKGROUND The term Spontaneous Intestinal Perforation (SIP) suggests a perforation in the gastrointestinal tract of a newborn with no demonstrable cause. METHODS Four neonates presenting with spontaneous bowel perforation were analyzed with respect to clinical presentation, management and outcome. RESULTS The mean age at presentation was 11.4 days. There were three males and one female. One of the neonates was preterm, very low birth weight and the other three were full term. Two neonates underwent emergency exploratory laparotomy and two were initially managed by peritoneal drainage in view of poor general condition; one of them improved and did not require further operative intervention. The preterm very low birth weight neonate was stabilized and explored after 48 hours. Intra-operatively, two of them had two ileal perforations each which required ileostomy; one had single perforation in the transverse colon which was primarily repaired. All four had an uneventful recovery. CONCLUSION SIP is a distinct clinical entity and has better outcome than neonates with intestinal perforation secondary to Necrotizing Enterocolitis (NEC).