Gastroenterology: malrotation: 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 · Gastroenterology: malrotation

Sample item

A 5-day-old develops sudden bilious vomiting. Upper GI contrast shows the duodenojejunal flexure on the right side with a corkscrew pattern. What is the urgent treatment?

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

The answer and the reasoning

B. Ladd procedure

Malrotation with midgut volvulus is a surgical emergency since bowel ischaemia occurs within hours. The Ladd procedure derotates the volvulus, divides peritoneal bands and widens the mesentery. Bilious vomiting in a neonate is a surgical emergency until proven otherwise.

Option by option

  • A. Antibiotics

    Antibiotics do not relieve volvulus.

  • B. Ladd procedure (correct)

    Correct. Ladd procedure for malrotation with volvulus.

  • C. Observation with feeds

    Delay risks necrosis of bowel.

  • D. Pyloromyotomy

    Pyloromyotomy is for pyloric stenosis.

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 B, Ladd procedure. Malrotation with midgut volvulus is a surgical emergency since bowel ischaemia occurs within hours.

Why is "Antibiotics" not the answer?

Antibiotics do not relieve volvulus.

Why is "Observation with feeds" not the answer?

Delay risks necrosis of bowel.

Why is "Pyloromyotomy" not the answer?

Pyloromyotomy is for pyloric stenosis.

What concept does this question test?

It tests Gastroenterology: malrotation in Pediatrics. The Ladd procedure derotates the volvulus, divides peritoneal bands and widens the mesentery. Bilious vomiting in a neonate is a surgical emergency until proven otherwise.

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 Gastroenterology: malrotation?

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.