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Pediatrics General 2bf3412a

Which one of the following is most suggestive of neonatal small bowel obstruction -

A
Generalized abdominal distension
B
Failure to pass meconeum in the first 24 hours
C
Bilious vomiting
D
Refusal of feeds
High-Yield Explanation
Ans. is 'c' i.e., Bilious vomiting "Bilious vomiting is the most common symptom". -- Internet Intestinal obstruction in newborn Presentation depends on the site of obstruction. 1. Proximal obstruction o A history ofpolyhydramnios is common. o The higher the obstruction in the intestine the earlier the infant will develop vomiting which may be bile stained. o Abdominal distension will be less prominent. o Obstipation is less common. 2. Distal obstruction o Abdominal distension and obstipation are more common. o Vomiting is less common. Note ? In neonates proximal intestinal obstruction are much more common than distal. So, bilious vomiting is the most common presentation of neonatal intestinal obstruction.

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