New roentgenographic signs of neonatal gastric perforation

Spontaneous gastric perforation in a neonate presenting with massive hydroperitoneum

We report the imaging findings in a case of neonatal spontaneous gastric perforation presenting as massive hydroperitoneum rather than pneumoperitoneum. Plain abdominal radiography showed a diffuse ground-glass opacity with paucity of bowel gas. Subsequent ultrasonography demonstrated numerous echogenic peritoneal fluid collections containing echogenic debris shown at surgery to be due to milk and bile.

Pneumoperitoneum: diagnosis from chest radiographs

Children under intensive care for various illnesses are usually followed closely with radiographic examinations of the chest. The recognition of a pneumoperitoneum as a complicating feature of these illneses depends on subtle radiographic signs that are frequently visible on the chest film studies. We have assembled and illustrated these findings in the hope that pediatricians will be better able to recognize this complication when it occurs.