Spontaneous Intestinal Perforation in Neonates Involving the Cecum: A Case Report

Abstract

Neonatal spontaneous colonic perforation in term neonates is a rare phenomenon, with caecal perforation being seldom reported. Therefore, this case report presents a rare case of spontaneous caecal perforation in a term neonate who presented with vomiting and abdominal distension on day two of life. On exploration, a single large full-thickness cecum perforation was noted. Histopathologic samples were negative for necrotizing enterocolitis and Hirschsprung's disease. Clinical awareness of this rare entity could help in preventing delays in imaging and prompt surgical management.

Three-dimensional computed tomography reconstruction diagnosed digestive tract perforation and acute peritonitis caused by Monopterus albus: A case report

“…CT constitutes an effective tool for accurate preoperative evaluation of living foreign bodies in clinic[ 3 ]. 3D CT reconstruction clearly displays anatomical structures, lesions and adjacent organs, improving diagnostic accuracy[ 6 ]. In the present case, preoperative 3D CT reconstruction accurately located a Monopterus albus outside the intestinal cavity with a perforation site, and the foreign body had damaged the mesentery in the small intestine, causing fluid and gas accumulation, as well as peritoneal thickening[ 5 ].…”

“…In the present case, according to clinical symptoms and signs, combined with plain 3D CT reconstruction, it was determined that the patient had digestive tract perforation, and a Monopterus albus had died after entering the abdominal cavity[ 5 ]. As a result, the patient’s abdominal cavity was seriously polluted, with a large amount of turbid yellow fluid and a small amount of feces attached to several intestinal areas, so it could be determined that the patient had “intestinal perforation” caused by a Monopterus albus [ 6 ]. The intestinal wall is relatively weak, and may burst out after Monopterus albus bites, which easily causes acute diffuse peritonitis[ 7 ].…”

Spontaneous Caecal Perforation in a Male Neonate: A Case Report

“…Gastrointestinal perforation is a surgical emergency condition in neonates that is commonly observed in the small intestine. Meanwhile, perforation of the colon is a rare condition [1], [2], and [3]. In premature neonates, colon perforation is most commonly caused by necrotizing enterocolitis (NEC), generally associated with Hirschsprung disease, meconium plug syndrome, small left colon syndrome, idiopathic perforation, anorectal malformation, and cystic fibrosis [1], [4].…”

“…Meanwhile, perforation of the colon is a rare condition [1], [2], and [3]. In premature neonates, colon perforation is most commonly caused by necrotizing enterocolitis (NEC), generally associated with Hirschsprung disease, meconium plug syndrome, small left colon syndrome, idiopathic perforation, anorectal malformation, and cystic fibrosis [1], [4]. In the term neonates, Hirschsprung disease is the most common cause, followed by NEC and spontaneous idiopathic perforation [5], [6].…”

“…In neonates, idiopathic caecal perforation is very rare. We presented a case report of a term male baby with idiopathic caecal perforation to highlight this surgical emergency in terms of clinical presentations, surgical management, and outcomes [1], [2], [7], [8].…”