Despite the recently improved neonatal intensive management, gastrointestinal perforation during the neonatal period is still a major challenge for pediatric surgeons. Objective: To review the effects of different clinical and operative parameters on the mortality of neonatal intestinal perforations. Patients and Methods: A retrospective study was done to 31 cases of neonatal intestinal perforation at the neonatal intensive care unit of Basrah children speciality hospital during the past four

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... d half years (July 2011 to December 2015). Information regarding the age, sex, gestational age, birth weight, clinical examination, x-rays value in diagnosis, causes and sites of perforations, types of operative procedures, and their effects on prognosis are all studied. Results: Males were affected more than females (a ratio of 3.4: 1); birth weight has a significant association with the prognosis (P-value of 0.045). Hirschsprung's disease was the commonest cause for perforation (29%), followed by necrotizing enterocolitis and jejunoileal atresia (16.1%, each). Idiopathic perforations constituted only 12.9%. Ileum was the commonest site of perforation (58.1%), followed by cecum (16.1%). Stoma creation was the commonest operative procedure performed. Other procedures like, primary anastomosis, and primary peritoneal drainage followed by laparotomy were also used. This study revealed high mortality rate (45.2%). Complications like sepsis, anastomotic leaks, or burst abdomen carried a high risk of death. Conclusions: High mortality rate is encountered, especially for necrotizing enterocolitis. In contrast to other study, Hirschsprung's disease is the commonest cause of perforation rather than necrotizing enterocolitis. Radiology has a relatively good accuracy in the diagnosis of intestinal perforations, although some cases were discovered intra-operatively. In this series, prompt accurate treatment with stoma creation harbored the best prognostic results; furthermore no benefits obtained from primary peritoneal d [...]