Pneumoperitoneum from a congenital defect of the gastric musculature.

A neonate at 31 weeks of gestation presented with aggravated abdominal distention on the 2th day after birth. The birth weight was 2110 g. Radiography of the abdomen showed pneumoperitoneum. The neonate was complicated with respiratory distress, electrolyte disturbance and coagulation disorders. Laparoscopic exploration revealed an approximately 6 cm length rupture of the greater curvature, extending from cardia to proximal pylorus. After trimming necrosis tissue of the edge, the gastric wall perforation was repaired surgically. Thinning and disappearance of muscularis were showed at edge of defect. The neonate's condition improved and oral feeding was started on postoperative day 7. The birth weight was 2300 g at discharge.