Neonatal gastric perforation usually occurs during the first
week of life, caused by trauma, ischemia, or rarely, as a spontaneous event.7,8 The
overall reported incidence is 1 in 2900 births, and it is more common
in males. Traumatic perforations usually are attributed to gastric
intubation or gastric overdistention from bag-mask ventilation,
esophageal intubation, or positive-pressure ventilation in the setting
of a tracheoesophageal fistula. Ischemic insults are not entirely
understood, but typically are associated with prematurity, birth asphyxia,
neonatal stress, or necrotizing enterocolitis. Spontaneous perforations
occur both in healthy infants as well as premature or low-birth-weight
patients.9 The most plausible etiology is multifactorial,
but may involve a congenital defect of the gastric wall musculature.