ABSTRACT

Gastric perforation in the neonatal period is rare; however, it continues to be associated with significant morbidity and mortality. Spontaneous neonatal gastric perforation is estimated to occur in 1 in 2900 live births and accounts for approximately 10"-15" of all gastrointestinal perforations in neonates and children. Gastric perforations in neonates can be broadly categorized as spontaneous, ischemic, or traumatic; however, in many instances, the etiology may be multifactorial. The clinical presentation of gastric perforation is variable. The majority of cases present within the first 7 days of life; however, later presentations are reported. The diagnosis of gastric perforation is made from the clinical history, physical examination, and radiographic studies. The differential diagnosis is broad and includes conditions that cause sudden deterioration in the newborn and conditions that produce vomiting and abdominal distention. Infants with gastric perforation develop septic parameters and need to be resuscitated accordingly. Neonates may become unstable prior to the development of free intra-abdominal air.