Spontaneous perforation of the gastrointestinal tract in infants during the first few hours or days of life is a paediatric emergency with a very grave prognosis if not treated surgically. The stomach is the most common site of perforation, but occasionally it occurs in the duodenum, small or large intestine. Failure to recognise the condition and carry out early surgical intervention usually results in fatal consequences. There are many causes of gastrointestinal perforation in the newborn. Although the aetiology is uncertain, some of the commonly accepted theories include congestion of the bowel wall secondary to asphyxia or septicaemia (Vargus and Levin, 1959), trauma coincident with delivery (Arnold, 1955), high gastric acidity, peptic ulcer and direct or indirect mechanical injury from lavage tubes, rectal thermometers or resuscitation efforts (Vargus and Levin, 1959). Congenital defects of the musculature, diverticula, meconium stasis, vascular insufficiency, pneumatosis cystoides intestinalis and c...