Appendiceal Perforation in the Neonate

ABSTRACT

Appendiceal perforation is uncommon in the neonate. The first reported case was by Diess in 1908, with approximately 111 additional cases reported since that time. However, if one excludes neonatal appendicitis associated with inguinal or umbilical hernias, necrotizing enterocolitis, meconium plug, and Hirschsprung's disease, the total would appear to be approximately 36 cases. We experienced a 12 days old boy with perforation of the appendix. A male newborn weighting 3000g was born by normal spontaneous vaginal delivary at 35 weeks gestation age to a 31-year-old mother who had premature rupture of membrane. He took feeding well for the first 5 days of life. After that, he began to have emesis of undigested milk, decreased activity and jaundice. He were admitted to the pediatrics and than phototheraphy was done. A 11-days after birth, he had progressive abdominal distension, fever, decreased activity, and vomitting. Erect abdominal radiography showed pneumoperitoneum. At exploratory laparotomy, a 0.8 X 0.6 cm sized perforation was noted at antimesenteric border of midportion of the appendix. Histologic section of the specimen showed ganglion cell and transmural inflammation.