Necrotizing enterocolitis manifesting with pneumatosis ani in a patient with gastroschisis

We present the case of a 1-month-old female with repaired gastroschisis who presented with pneumatosis ani as the initial manifestation of necrotizing enterocolitis (NEC). NEC may present in as much as 20% of patients with gastroschisis. This relationship should prompt urgent evaluation and management as soon as any sign or symptom of the disease appears. Even though pneumatosis ani is a rare clinical finding, the anal region should always be examined in all patients where NEC is suspected.