Upper gastrointestinal bleeding in a term neonate requiring haemostasis by laparotomy

We report a case of a term neonate who developed massive haematemesis at 15 hours of life without identifiable risk factors. Despite conservative management, the bleeding persisted, resulting in haemorrhagic shock and anaemia. Endoscopy was not feasible due to a large intragastric haematoma, so surgical haemostasis was performed, revealing diffuse gastric erosion and multiple bleeding ulcers and the neonate recovered well postoperatively. This report shows that life-threatening bleeding can occur even in term neonates without identifiable risk factors. In cases of ongoing massive bleeding in which conservative and endoscopic management are unsuccessful or not feasible, surgical haemostasis may need to be considered.