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Idiopathic neonatal colonic perforation- a case report
Nilottpal Dey1, Lekhachandra Sharma, Birkumar Sharma
1Regional Institute of Medical Sciences, Imphal, Manipur India.
The Indian Journal of Surgery
|June 2, 2012
Summary
Idiopathic neonatal colonic perforation is rare. This case highlights a healthy infant with transverse colon perforation, treated successfully with primary closure, emphasizing the need to consider idiopathic causes.
Area of Science:
- Pediatric Surgery
- Neonatal Medicine
- Gastroenterology
Background:
- Neonatal colonic perforation is an uncommon surgical emergency.
- Causes include Hirschsprung's disease, necrotizing enterocolitis, and congenital anomalies.
- Idiopathic perforation without identifiable cause is exceptionally rare.
Purpose of the Study:
- To report a unique case of idiopathic neonatal transverse colon perforation.
- To discuss the diagnostic and management challenges in such rare cases.
- To highlight the importance of considering idiopathic causes in neonatal colonic perforation.
Main Methods:
- Case report of a 21-day-old female neonate presenting with abdominal distention and constipation.
- Diagnostic imaging included abdominal radiography revealing massive pneumoperitoneum.
- Surgical exploration identified transverse colonic perforation near the splenic flexure, treated with primary closure.
Main Results:
- The neonate, previously healthy, had no identifiable cause for the colonic perforation.
- Intraoperative findings excluded common causes like Hirschsprung's disease or necrotizing enterocolitis.
- Primary closure of the perforation was successful, with no postoperative complications.
- The infant demonstrated normal weight gain and remained asymptomatic at follow-up.
Conclusions:
- Idiopathic neonatal colonic perforation, though rare, can occur in healthy neonates.
- Primary closure is a viable treatment option for such cases.
- This case underscores the diagnostic challenge and the need for a broad differential diagnosis in neonatal colonic perforation.
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