Localized intestinal perforation following intravenous indomethacin for patent ductus arteriosus

We describe a very low birth weight infant given intravenous indomethacin for a symptomatic patent ductus arteriosus who subsequently developed a gastrointestinal perforation. Although this is a well-known complication of enteral preparations, it has not been described with the intravenous form. Various mechanisms described in the literature by which the intravenous route of administration may compromise the bowel are presented. Although rare, gastrointestinal complications with intravenous indomethacin may become more prevalent with its increased use.