Neonatal duodenal perforation.

Duodenal perforation in neonates is uncommon, and has been described rarely in the third part of the duodenum. Gastrointestinal perforations without an obvious cause have been labeled as "spontaneous." We report a case of perforation in the third part of the duodenum in a premature infant for which there was no obvious cause. In such "spontaneous" perforations, multifactorial etiology is likely and possible factors are discussed. The high mortality rate in such patients can be improved by early diagnosis and prompt resuscitation followed by surgery. Peritoneocentesis plays an important diagnostic role. It is also therapeutic in relieving the respiratory distress caused by free intraperitoneal air. The majority of duodenal perforations are amenable to primary closure at surgery and this should be the treatment of choice.