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Over a 7-year period (1990-1997) spontaneous gastric perforation was diagnosed in five neonates. The mean gestational age and birth weight were 33/40 weeks and 1.83 kg, respectively. All patients presented with severe abdominal distention and frank pneumoperitoneum on roentgenograms. All perforations were on the anterior wall of the greater curvature and were managed by prompt laparotomy and primary closure of the perforation. No gastrostomy was used, however, peritoneal drainage was used in all cases. There was no mortality or morbidity. An attempt to understand the possible etiology together with a review of the literature is presented.
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