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Incarcerated hernia with ileal perforation in an extreme preterm infant
  1. Alicia May Lim1,
  2. Te-Lu Yap2 and
  3. Juin Yee Kong1
  1. 1Neonatology, KK Women's and Children's Hospital, Singapore
  2. 2Paediatric Surgery, KK Women's and Children's Hospital, Singapore
  1. Correspondence to Dr Alicia May Lim; alicia.may.lim{at}


We describe a case of a premature 24 weeks gestation infant who presented with clinical lability and abdominal distention with initial concerns of necrotising enterocolitis. On further examination, a right inguinal hernia was noted and serial abdominal X-rays showed bowel loop dilatation with intramural air and no perforation. However, the hernia was recurrent and later found to be not reducible. He underwent right groin exploration. Intraoperatively, distal ileal perforation was noted and he was found to have an additional five sites of perforation. He had a stoma sited at the left iliac fossa as well as primary anastomosis at the site of the second to fifth perforations. He had a stormy postoperative period but is currently doing well. Although obstructed hernias are rare in the initial course of an extreme preterm infant, it should not be missed as a cause of intestinal obstruction and early surgical opinion should be sought.

  • Neonatal and paediatric intensive care
  • Neonatal health

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: AML, T-LY, JYK. The following authors gave final approval of the manuscript: AML, T-LY, JYK.

  • 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.