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Neonatal perforated appendicitis: a presentation of necrotising enterocolitis?
  1. Prathit Naik,
  2. Rajendra Prasad Anne,
  3. Sheila Samanta Mathai and
  4. Nitin Pai
  1. Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
  1. Correspondence to Dr Rajendra Prasad Anne; rajendra.anne{at}


In this case report, we present a late preterm growth-restricted neonate who developed signs of feeding intolerance on the second day of life, which progressed to frank peritonitis with perforation by the end of the second week of life. As necrotising enterocolitis was considered the most likely diagnosis, a glove drain was placed in the flanks. The neonate did not improve, and surgical exploration was done after medical stabilisation. On exploration, the neonate was found to have appendicular perforation and an appendicectomy was performed. During surgery, the rest of the gut was noted to be healthy. Histopathological examination of the appendix showed transmural inflammation, focal infarction and perforation. The postoperative period was uneventful, and the neonate showed rapid improvement and reached full enteral feeding in the next 5 days. Antibiotic therapy promptly resolved bacterial peritonitis, and the neonate was discharged successfully.

  • Neonatal and paediatric intensive care
  • Gas/Free Gas

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  • Contributors The following authors were responsible for the drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: PN, RPA, SSM and NP. The following authors gave final approval of the manuscript: PN, RPA, SSM and NP.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.