Barseghyan K, et al. - Researchers conducted this retrospective case-control study to compare serum alkaline phosphatase levels in infants with bowel perforation secondary to spontaneous intestinal perforation (SIP) vs surgical necrotizing enterocolitis (NEC), and then examine the possible role of serum alkaline phosphatase in differentiating infants with these conditions. The sample consisted of infants admitted with bowel perforation from 2005 to 2015. Demographic and prenatal data, postnatal exposures, and clinical, laboratory, and radiographic findings have been obtained from inpatient medical records and analyzed utilizing regression analysis. Of the 114 outborn infants that were included, 48 infants had SIP (cases) and 66 had NEC (controls). A transient increase in serum alkaline phosphatase level as compared with NEC is independently correlated with SIP. Research is needed to confirm the role of alkaline phosphatase in SIP diagnosis, and have potentially important clinical and prognostic implications.