Spontaneous jejunal perforation in a term neonate: case repo
Spontaneous Intestinal Perforation (SIP) of the newborn is usually a focal intestinal perforation typically found at the terminal ileum occurring primarily in preterm and very low birth weight babies. Published in the Indian Journal of Neonatal Medicine and Research, the authors report a case of spontaneous jejunal perforation in a four-day old term neonate who underwent successful surgical intervention.

A four-day-old female neonate was referred in view of abdominal distension. At admission, the baby had clinical features of sepsis in the form of tummy toe difference, mottling, decreased activity, poor perfusion and gross abdominal distension. Abdominal radiograph showed air under the diaphragm and fluid levels in pelvis. The platelet count decreased to 81,000/cu.mm and platelet transfusion was given prior to surgery.

Laparotomy done through right supra umbilical transverse incision showed mid jejunal perforation with bile and pus in the abdomen. Jejunal perforation was closed by interrupted sutures in 2 layers using 5-0 MERSILK and peritoneal lavage was done. Rest of the intestine was normal and hence, biopsy was not taken.

Postoperative period was uneventful. Feeds were started on the 7th postoperative day and baby tolerated feeds well. Baby was accepting breastfeeds and was discharged on day 16 of life.

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