# Perforated Acute Appendicitis Presenting as Pneumoperitoneum in a Preterm Neonate: A Case Report and Literature Review

## TL;DR

A preterm neonate with perforated appendicitis showed pneumoperitoneum on imaging, leading to surgical confirmation and treatment.

## Contribution

This case highlights the rare presentation of pneumoperitoneum in neonatal appendicitis and emphasizes the need for prompt diagnosis.

## Key findings

- Pneumoperitoneum was observed on plain radiography in a preterm neonate.
- Surgical exploration confirmed perforated acute appendicitis.
- The case underscores the importance of considering appendicitis in neonates with pneumoperitoneum.

## Abstract

Acute appendicitis is rare in the neonatal population, and delayed diagnosis is associated with increased morbidity and mortality. Pneumoperitoneum is infrequently identified on plain radiography in cases of neonatal appendicitis, which can result in delays in diagnosis and intervention. In this case, we report a 15‐day‐old preterm female neonate who presented with irritability and abdominal distention. A plain abdominal radiograph demonstrated significant pneumoperitoneum, and surgical exploration revealed perforated appendicitis.