Gastric perforation: A devastating surgical emergency in a preterm neonate with multidrug-resistant <i>Klebsiella pneumoniae</i> sepsis – A case report

A preterm twin neonate with Klebsiella pneumoniae developed free gas within the peritoneal cavity on D3 of life due to gastric perforation. Gastric perforation in neonates, especially preterm neonates, is a devastating surgical emergency and it is a major challenge for the treating physician with a mortality rate of 30–50%. It was first reported by Siebold. Many etiologies including ischemia, aerophagy, trauma, absent muscular layer and sepsis are considered. Whatever the etiology the intervention is needed urgently to prevent mortality and morbidity. We present a preterm neonate with multidrug-resistant K. pneumoniae who developed sudden abdominal distension needing exploration and repair of gastric perforation. Despite being managed by early resuscitation and stabilisation with surgical repair of the defect, he succumbed to illness post-surgery.