Paediatric surgery: necrotising enterocolitis surgery: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric surgery: necrotising enterocolitis surgery

Sample item

A preterm infant of 1.2 kg on day 9 has abdominal distension and bloody stools, and radiography showed pneumatosis intestinalis. Now there is free air under the diaphragm. What is the management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Surgical intervention with laparotomy or peritoneal drain

Necrotising enterocolitis causes ischaemic and inflammatory necrosis of the intestine in premature infants. Pneumatosis intestinalis is the radiological hallmark, and pneumoperitoneum signifies perforation, which is an absolute indication for surgery. Options are laparotomy with resection and stoma, or peritoneal drain in very small infants.

Option by option

  • A. Repeat radiograph after 24 hours

    Waiting allows peritonitis, sepsis and death.

  • B. Surgical intervention with laparotomy or peritoneal drain (correct)

    Correct. Perforation requires source control.

  • C. Continue bowel rest and antibiotics alone

    Medical therapy alone is for stage II disease without perforation.

  • D. Oral feeds with probiotics

    Feeding would be dangerous with perforated bowel.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Surgical intervention with laparotomy or peritoneal drain. Necrotising enterocolitis causes ischaemic and inflammatory necrosis of the intestine in premature infants.

Why is "Repeat radiograph after 24 hours" not the answer?

Waiting allows peritonitis, sepsis and death.

Why is "Continue bowel rest and antibiotics alone" not the answer?

Medical therapy alone is for stage II disease without perforation.

Why is "Oral feeds with probiotics" not the answer?

Feeding would be dangerous with perforated bowel.

What concept does this question test?

It tests Paediatric surgery: necrotising enterocolitis surgery in General Surgery. Pneumatosis intestinalis is the radiological hallmark, and pneumoperitoneum signifies perforation, which is an absolute indication for surgery. Options are laparotomy with resection and stoma, or peritoneal drain in very small infants.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric surgery: necrotising enterocolitis surgery?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.