Perforation of the bowel in the newborn as a complication of exchange transfusion

Spontaneous perforation of the bowel without evidence of intestinal obstruction is reported in six infants who had exchange transfusions for rhesus incompatibility, and in a seventh who had prolonged intravenous fluids via the umbilical vein. The pathological findings resemble those found in acute necrotizing enterocolitis in adults, which is known to be associated with arterial hypotension. The cause in these infants may also be due to a period of hypotension during the transfusion, and hypoxia and superimposed infection may also play an important part.