Neonatal perforated appendicitis. Case report.

Introduction and importance: Neonatal appendicitis is a rare condition with high morbidity and mortality due to its late diagnosis in favor of more common pathologies. There are few reported cases of neonatal appendicitis and even fewer of antenatal appendicitis.

Case presentation: We report a neonate presenting with abdominal distention and gastric emesis in the setting of a suspected congenital abdominal mass, later diagnosed with neonatal appendicitis requiring intestinal resection and anastomosis.

Clinical discussion: Neonatal appendicitis presents with nonspecific symptoms and may often be mistaken for enterocolitis or intestinal malrotation. Additional imaging, including abdominal radiographs, ultrasound, or computed tomography, may facilitate diagnosis.

Conclusion: Neonatal appendicitis is a rare entity with a challenging diagnosis due to the lack of specific signs. In the current case, the patient was referred to our institution with an antenatal ultrasound showing a right flank mass which resulted in abscess formation and perforated appendicitis.