Diagnosing intestinal perforation: a new approach.

Spontaneous intestinal perforation has been shown to be a significant morbidity in the extremely low birthweight neonate. Occult spontaneous intestinal perforation (SIP), without pneumoperitoneum on abdominal radiograph, typically occurs in neonates > 2 weeks of age and is usually diagnosed by visualization of particulate matter seen on an abdominal ultrasound. We present a case of a 25-week growth-restricted neonate at 12 days of life who was diagnosed with occult SIP by a novel mechanism.