ABSTRACT
Spontaneous intestinal perforation (SIP) in the newborn, also known as focal, idiopathic, or isolated intestinal perforation, typically affects extremely low birth weight (ELBW) or very low birth weight (VLBW) premature babies. The typical findings in SIP are those of a single perforation on the antimesenteric border of the terminal ileum, although perforation of the jejunum or colon has occasionally been described. SIP occurs predominantly in VLBW or ELBW premature babies born between 25 and 27 weeks' gestation. The key differential diagnosis is necrotizing enterocolitis (NEC) with gastrointestinal perforation. It is important to try and distinguish these two conditions because they are managed differently and have a different outcome. There are no clinical, laboratory, or radiologic features that can reliably distinguish SIP from NEC, but the earlier age of onset of the perforation and absence of pneumatosis intestinalis on the plain abdominal radiograph are features favoring the diagnosis of SIP.
