A full term, 3.2kg. colored male was born on 3rd Dec., 1967 following uncomplicated gestation. A forceps delivery due to placenta previa. Respirations began without difficulty at birth and no form ef resuscitation was required. Normal meconium stools were neted 12 hours following delivery.
Thirty hours post-partum, acute onset of massive abdominal distention, rapid shallow respirations and high fever developed. An upright film of the abdomen revealed massive pneumoperitoneum(Fig. 1).
Oxygen inhalation, fluid therapy and rectal tube insertion were not relieved his marked respiratory difficulty and laparotomy was carried out 20 hours after onset of symptoms.
At operation, under general endotracheal anesthesia, a 5 cm. linear tear of the greater curvature of the stomach extending downward from the midportion of greater curvature side was found. There was no active bleeding from the apparently necrotic edges of th rupture. A distal hemigastrectomy was performed with gastrojejunostomy due to extensive defects in gastric musculature.
His marked respiratory difficulty was slightly relieved with operation but high fever persisted. The infant expired 14 hours after operation.
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