Paediatric imaging: necrotising enterocolitis: practice question

A Radiology 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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Radiology · Paediatric imaging: necrotising enterocolitis

Sample item

A premature neonate on feeds develops abdominal distension and bloody stools, and the abdominal radiograph shows linear and bubbly gas within the bowel wall. What is the sign?

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

The answer and the reasoning

A. Pneumatosis intestinalis of necrotising enterocolitis

Gas within the bowel wall due to bacterial fermentation in ischaemic mucosa is pneumatosis intestinalis. Portal venous gas and pneumoperitoneum signify advanced disease. Feeds are withheld and antibiotics started, with surgery for perforation.

Option by option

  • A. Pneumatosis intestinalis of necrotising enterocolitis (correct)

    Correct. Intramural gas in a premature infant is NEC.

  • B. Rigler sign without disease

    Rigler sign indicates pneumoperitoneum, not mural gas.

  • C. Air-fluid level of ileus alone

    A simple air-fluid level does not explain the clinical picture.

  • D. Double bubble

    Double bubble indicates duodenal atresia.

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.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Pneumatosis intestinalis of necrotising enterocolitis. Gas within the bowel wall due to bacterial fermentation in ischaemic mucosa is pneumatosis intestinalis.

Why is "Rigler sign without disease" not the answer?

Rigler sign indicates pneumoperitoneum, not mural gas.

Why is "Air-fluid level of ileus alone" not the answer?

A simple air-fluid level does not explain the clinical picture.

Why is "Double bubble" not the answer?

Double bubble indicates duodenal atresia.

What concept does this question test?

It tests Paediatric imaging: necrotising enterocolitis in Radiology. Portal venous gas and pneumoperitoneum signify advanced disease. Feeds are withheld and antibiotics started, with surgery for perforation.

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 imaging: necrotising enterocolitis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.