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A premature infant, second of twins, was born in assisted breech presentation with a pinhole perforation at the right colonic flexure. Similar colonic perforations have been reported earlier in breech-born infants. The genesis of this type of intestinal perforation is discussed. It is assumed that external compression of the cervical ring during delivery in assisted breech presentation can cause a rapid pressure rise inside the colonic flexures. In model studies in rabbits and in a postmortem specimen it is shown that a pinhole perforation of the intestinal wall occurs when the pressure inside the lumen increases rapidly.
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Accepted: October 29, 1973
© 1974 Published by Elsevier Inc.