Perforated Appendix in a Neonate: A Review of Literature and a Case Report from Northern Tanzania

Acute perforated appendicitis is rare in neonates and is associated with high morbidity and mortality. This is mainly because the rarity of the pathology and the abnormal clinical features cause delays in diagnosis and definitive management. We report a case of a premature neonate who presented with sudden onset of abdominal distension associated with an inability to pass stools. The initial abdominal X-ray showed free air under the right hemi-diaphragm. An emergency laparotomy was performed revealing a perforation at the appendicular tip. An appendectomy was done, and the neonate recovered well with a mild surgical site infection during the course of recovery. Neonatal perforated appendicitis is rare, and clinicians need to consider it as a differential diagnosis due to the atypical presentations. This preterm neonate presented with clinical features of intestinal obstruction and was found at laparotomy to have a perforated appendix at the tip due to neonatal appendicitis.