Gastrointestinal perforation caused by obstruction in Trinidadian neonates.

A review was conducted of neonates treated over a 7-year period for gastrointestinal tract perforation secondary to obstruction, for comparison with previous reports. Demographic and clinical characteristics, results of laboratory studies, underlying diagnoses, surgical treatment, and outcomes were studied. Only 1 of the 6 babies was premature. The underlying cause of obstruction was Hirschsprung's disease (HD) twice, duodenal, sigmoid, and rectal atresia, and malrotation with midgut volvulus, once each. The perforation was located in the stomach in two cases, the jejunum in one case, and the large bowel in 3 children. There were no fatalities. Unusual features were that both gastric perforations were secondary to duodenal obstruction, and only 1 infant was premature. The jejunum was affected once, secondary to HD of the descending colon. In contrast to previous reports, there were no perforations of the ileum caused by intestinal obstruction in this neonatal population during the period reviewed.