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June 1968

Idiopathic Colon Perforations in the Newborn

Author Affiliations

Tulsa, Okla
From the Department of Surgery, St. John's Hospital, Tulsa, Okla.

Arch Surg. 1968;96(6):1008-1014. doi:10.1001/archsurg.1968.01330240154035

MOST surgeons and pediatricians in a lifetime of practice will not encounter a single case of perforation of the colon in the newborn. About one half of these cases have an obstructive etiology including adhesive bands,1 Hirschprung's disease,1-3 imperforate anus,1-3 colon atresia,1,4 meconium plug,5 volvulus,1 and stenosis.1 Occasionally trauma6 may be a factor. The obscure or idiopathic group constitutes the other half of neonatal colon perforations. It is this group that will be considered.

Seventy cases of idiopathic neonatal colon perforation have been reported in the American and English literature; there has been only nine survivors. In 1951, Doyle7 described a 24-hour-old infant with a spontaneous perforation of the ascending colon who recovered after simple closure of the perforation. A 48-hour-old infant with a spontaneous rectosigmoid perforation was reported by Standard8 in 1952. Recovery followed a transverse colostomy without closure