Abstract

AIM: Radiologic presentations of intestinal perforation in newborn period were reviewed in order to highlight unusual radiologic findings. MATERIAL AND METHOD: Between August 2006 and December 2008, 14 neonates with intestinal perforation, treated in the newborn intensive care unit of our hospital, were evaluated retrospectively regarding early diagnostic signs in abdominal radiology. FINDINGS: Although all patients had intestinal perforation treated by emergency surgery, intraperitoneal free air was not detected in 5 patients preoperatively. Six patients' erect radiogram revealed free subdiaphragmatic air. Three patients' radiograms had subtle findings of pneuperitoneum such as, football sign, falciform ligament sign, localized free air superposed on liver or over fundus. CONCLUSION: The plain erect abdominal and lateral decubitus radiographs of abdomen remain to be the mainstay of radiological assessment of the patient presenting with clinical fear resembling intestinal perforation. However, supine radiographs may represent subtle signs of pneumoperitoneum. If these less well known signs are missed, mortality and morbidity may increase. Awareness of these subtle clues, may provide an earlier diagnosis.