2009 Volume 45 Issue 2 Pages 231-234
A 12-day-old boy was referred to our hospital because of abdominal distention, bilious vomiting and melena with a suspected diagnosis of mid-gut volvulus and malrotation. He had been fed with breast milk since one day after birth. Although upper gastrointestinal contrast study and contrast enema did not reveal mid-gut volvulus or malrotation, exploratory laparotomy was performed because strangulation of the ileus was not excluded. A laparotomy revealed perforation of the appendix and malrotation without volvulus. We diagnosed panperitonitis due to perforated appendicitis and performed an appendectomy. It is difficult to make the diagnosis prior to surgery because neonatal appendicitis is extremely rare and the clinical signs are not specific. When treating neonates with ileus and melena, the diagnosis of neonatal appendicitis should be included in the differential diagnosis.
