Neonatology: necrotising enterocolitis: practice question

A Pediatrics 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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Pediatrics · Neonatology: necrotising enterocolitis

Sample item

A preterm infant of 30 weeks on day 8 develops feed intolerance, abdominal distension and bloody stools. An abdominal X-ray shows linear lucencies in the bowel wall. What is the finding called and the immediate management?

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

The answer and the reasoning

A. Pneumatosis intestinalis; nil by mouth, nasogastric decompression and antibiotics

Necrotising enterocolitis shows pneumatosis intestinalis, which is gas within the bowel wall, and may progress to portal venous gas or perforation. Management is bowel rest, gastric decompression, broad-spectrum antibiotics and monitoring, with surgery for perforation. Prematurity is the main risk factor.

Option by option

  • A. Pneumatosis intestinalis; nil by mouth, nasogastric decompression and antibiotics (correct)

    Correct. Pneumatosis intestinalis with bowel rest and antibiotics.

  • B. Thumbprinting; start increased feeds

    Increasing feeds would worsen necrotising enterocolitis.

  • C. Rigler sign; urgent feeds

    Rigler sign indicates free air and requires surgery, not feeding.

  • D. Double bubble sign; duodenal atresia surgery

    A double bubble sign is seen in duodenal atresia and presents on day 1.

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 Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Pneumatosis intestinalis; nil by mouth, nasogastric decompression and antibiotics. Necrotising enterocolitis shows pneumatosis intestinalis, which is gas within the bowel wall, and may progress to portal venous gas or perforation.

Why is "Thumbprinting; start increased feeds" not the answer?

Increasing feeds would worsen necrotising enterocolitis.

Why is "Rigler sign; urgent feeds" not the answer?

Rigler sign indicates free air and requires surgery, not feeding.

Why is "Double bubble sign; duodenal atresia surgery" not the answer?

A double bubble sign is seen in duodenal atresia and presents on day 1.

What concept does this question test?

It tests Neonatology: necrotising enterocolitis in Pediatrics. Management is bowel rest, gastric decompression, broad-spectrum antibiotics and monitoring, with surgery for perforation. Prematurity is the main risk factor.

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 Neonatology: necrotising enterocolitis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.