Neonatal Gastric Perforation Temporally Associated with Nasogastric Tube Insertion: A Case Report

Background

Neonatal gastric perforation (NGP) is a rare but potentially life-threatening condition associated with substantial morbidity and mortality. Approximately half of reported cases are idiopathic or spontaneous, while the remainder are attributed to identifiable causes, including congenital gastric wall defects, hypoxic-ischemic injury, and iatrogenic trauma related to nasogastric tube (NGT) insertion, particularly in premature and low-birth-weight infants. Early diagnosis and prompt surgical intervention are critical for improving outcomes. We report a case of gastric perforation temporally associated with nasogastric tube insertion in a preterm, small-for-gestational-age (SGA) neonate, highlighting the diagnostic challenge of distinguishing mechanical from ischemic etiologies, together with management and preventive considerations.