Perforated acute appendicitis in a term neonate

Abstract

Acute appendicitis is rare in term neonates. In most of the reported cases, it is seen as a complication of necrotizing enterocolitis, Hirschsprung's disease, cystic fibrosis, meconium plug, inguinal hernia, umbilical hernia, Group B Streptococcal septicemia and chorioamnionitis. A surviving term male newborn with isolated acute appendicitis with perforation is reported. A high index of suspicion of acute appendicitis, early surgery and the importance of a thorough search for a perforation in cases of neonatal acute abdominal distention is stressed. Literature of this rare condition is reviewed briefly.

Etiology of neonatal gastric perforations: Review of 10 years’ experience

“…In addition to these factors, in the present series there was dexamethasone administration in one case (patient 4) as a predisposing factor, which had been identified by Nagaraj et al 14 The most notable difference from past reports was the presence of chorioamnionitis in the mothers in two cases. In the literature this relationship was reported in neonatal acute appendicitis 15,16 . As far as we know this relationship has not been mentioned before with NGP.…”

“…In the literature this relationship was reported in neonatal acute appendicitis. 15,16 As far as we know this relationship has not been mentioned before with NGP.…”

Neonatal acute appendicitis: a proposed algorithm for timely diagnosis

“…3). Other authors have recommended early exploratory laparotomy [11,17]. In our experience, surgery is often deferred, as clinicians presume a diagnosis of NEC, which is more common and may be treated conservatively.…”

Acute neonatal appendicitis: A diagnosis to consider in abdominal sepsis

“…In our case the suspected diagnosis was perforated necrotizing enterocolitis. But the differential diagnosis should also consider spontaneous intestinal perforation, Hisrchprung disease, intestinal volvulus or acute gastroenteritis [6,14].…”