Spontaneous gastroduodenal disruption in neonate.

A 2-day-old female presented with massive abdominal distention and respiratory distress. An erect abdominal X-ray film revealed a pneumoperitoneum of saddlebag configuration. The patient was resuscitated and a peritoneal drain was put through the right flank. Air and bile drained, and the respiratory distress was relieved. After the patient had stabilised haemodynamically, an exploratory laparotomy revealed a total gastroduodenal disruption. A gastrojejunostomy was done; the pyloric and duodenal ends were closed in two layers. The postoperative course was uneventful. We report this case for its unusual and rare presentation.