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What is spontaneous intestinal perforation?
A spontaneous intestinal perforation, or SIP, is a small tear in part of the digestive system called the intestines.
The tear is spontaneous, or isolated, because babies with SIP usually have no other problems with their digestive systems.
The SIP may allow some contents of the intestines to leak out into the abdomen (belly).
This can cause irritation or an infection.
What are the symptoms of SIP?
Babies with SIP often have swollen bellies (abdominal distention), low blood pressure (hypotension), and trouble breathing. In some cases, the abdomen may look a little gray or blue.
How common is SIP?
SIP occurs in fewer than 5 in 100 premature babies with very low birth weight (less than 3.5 pounds).
SIP is uncommon in full-term babies or babies with normal birth weight.
How is SIP diagnosed?
In babies who have symptoms of SIP, X-rays are used to look for signs that the contents of the intestines are leaking into the abdomen.

How is SIP treated?
SIP is treated in two steps. First, the health care team tries to make the baby feel better. They may:
• Stop putting food or medicines into the baby’s digestive system (by mouth or through a tube)
• Feed the baby and give medicines intravenously (through an IV)
• Use suction to release gas from the abdomen
• Use antibiotics to treat infections
Second, the health care team treats the SIP itself. There are 2 main types of treatment:
• Peritoneal drainage to remove fluid from the abdomen
through a drain. The drain stays in place for several days.
The goal is to give the tear time to heal itself.
• Surgery to fix the tear.
The choice of treatment depends on many factors. Talk to your health care team about the best treatment for your baby.
How will I know how my baby is doing?
The NICU team will keep you up-to-date on your baby’s progress.
It often takes several weeks for the intestines to heal before the baby can start eating by mouth.
What will happen next?
Many babies respond well to treatment for SIP. However, each baby is different. Talk to your baby’s health care team. They can answer any questions you have about your baby

Abdomen – belly
Abdominal distension
swollen belly
Digestive system – group of
organs that process food. It
includes the mouth, stomach,
liver, pancreas, and intestines
Drain – a small plastic tube used
to remove fluid
Intestinal – part of the
digestive system
Intravenous – through a vein
Hypotension – low blood pressure
Perforation – small hole or tear
Peritoneal – relating to the thin
layer of tissue that lines the
Spontaneous – does not have a
known cause

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