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Spontaneous Neonatal Gastric Perforation: A Case Report.
Abir Azirar1, Mohammed Ech-Chebab2, Anass Ayyad3
1Department of Pediatrics, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Mohammed First University of Oujda, Oujda, MAR.
Cureus
|August 18, 2025
Summary
Spontaneous gastric perforation (SGP) is a rare neonatal emergency. Early diagnosis and surgical intervention are crucial, but even then, preterm infants face a high mortality risk from this condition.
Area of Science:
- Neonatal Surgery
- Pediatric Gastroenterology
- Critical Care Medicine
Background:
- Spontaneous gastric perforation (SGP) is a rare, life-threatening surgical emergency in neonates.
- Preterm infants are particularly vulnerable to SGP.
Observation:
- A 33-week preterm male neonate presented with sudden abdominal distension and bilious vomiting on day two of life.
- Radiography revealed massive pneumoperitoneum, leading to emergency exploratory laparotomy.
- A 2 cm gastric perforation was identified and primarily repaired.
Findings:
- Despite prompt surgical repair and intensive care, the neonate developed sepsis, shock, and multiorgan failure.
- The infant succumbed within 48 hours postoperatively, highlighting the aggressive nature of SGP.
Implications:
- This case emphasizes the critical need for a high index of suspicion for SGP in neonates with acute abdominal symptoms.
- Early diagnosis and rapid surgical intervention are paramount for improving outcomes in these high-risk infants.
- The high mortality rate underscores the severity of SGP, especially in preterm neonates.
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