A Rare Case of Neonatal Appendiceal Perforation Presenting as Intestinal Obstruction

Neonatal appendicitis is a rare and often misdiagnosed condition due to its nonspecific clinical presentation, commonly mimicking necrotising enterocolitis or intestinal obstruction. We report a case of a 26-day-old term female neonate who presented with fever, diarrhea, bilious vomiting, and abdominal distension. Imaging suggested small bowel obstruction. During exploratory laparotomy, a perforated appendix with localized adhesions was found, along with a distended cecum and collapsed colon. Appendectomy, ileostomy, and colonic mapping biopsies were performed. Histopathology confirmed appendicitis with the presence of ganglion cells. The child recovered fully and is thriving well at 6-month follow-up. This case highlights the importance of considering appendicitis in the differential diagnosis of neonatal intestinal obstruction to avoid delays in treatment and reduce the perforation and mortality rate.