Spontaneous intestinal perforation and multiple thrombotic events in a neonate with thrombophilia

Abstract

Abstract Spontaneous intestinal perforation (SIP), a rare complication in neonates, was diagnosed in a preterm newborn. After surgery, small bowel histology showed acute ischemic changes and one area of perforation. Fibrin thrombus in the submucosal capillary vessels suggested a thrombotic mechanism in the pathogenesis. Subsequently, two severe asynchronous thrombotic events developed: cerebral sinovenous thrombosis and renal vein and inferior vena cava thrombosis. The neonate presented with hypercoagulability and factor V Leiden heterozygosity. This is the first association of SIP with inherited thrombophilia and thrombotic events in a neonate, suggesting hypercoagulability as a new research focus for pathogenesis of this enigmatic disease.