Perforation of a Gastric Ulcer Associated with Intracranial Hemorrhage in a Newborn Infant1

That perforated gastric ulcers are of unusual occurrence in infants and children is well established. In a review of 248 cases of ulceration of the stomach in children, Theile (1, 2) found only 5 instances of perforation. Pendergrass and Booth (3) have also stressed the absolute and relative rarity of this complication in childhood as compared to its incidence in later life. The etiology of ulceration in children, with or without subsequent perforation, is obscure. Adler (4) attributed it to autodigestion occurring as a result of small hemorrhages during parturition. Other causative agents which have been suggested are direct trauma, infection, local disturbance of circulation from congestion, embolism, thrombosis, and vascular disease. The brilliant work of Cushing (5), following that of German investigators (7, 8), established a neurogenic origin for many gastric ulcers. Animal experiments and his observation of multiple ulcers of the stomach, frequently with perforation, following brain surgery, more e...