Pati, SanandaChaki, BhushanRoy, AtanuDe, Sangita2026-05-252026-05-252012https://hdl.handle.net/20.500.14572/6242Sananda Pati Graduate Trainee, Junior Resident, Department of Paediatrics, Burdwan Medical College and Hospital, Burdwan Bhushan Chaki Post Graduate Trainee, Department of Paediatrics, Burdwan Medical College and Hospital, Burdwan Atanu Roy Assistant Professor, Department of Paediatrics, Burdwan Medical College and Hospital, Burdwan Sangita De Post Graduate Trainee, Department of Paediatrics, Burdwan Medical College and Hospital, BurdwanAbstract: Common causes of pneumoperitoneum in neonates includes necrotising enterocolitis (NEC), specific infections, gastro intestinal obstruction, iatrogenic causes, idiopathic focal intestinal perforation, perforation secondary to intra thoracic pathology, mechanical ventilation etc. Primary peritoneal drainage and exploratory laparotomy remain the definitive management of pneumoperitoneum in neonates. Here we report a case of suspected spontaneous idiopathic intestinal perforation managed conservatively with monitoring of vital signs. The neonate had an uneventful recovery. This case highlights the need to identify infants with benign or non surgical causes of pneumoperitoneum thus avoiding unnecessary laparotomies and referrals in these vulnerable neonates.en-USPneumoperitoneumNecrotising enterocolitis (NEC)Spontaneous intestinal perforationArticle