Paediatric surgery: jejunoileal atresia: 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: jejunoileal atresia

Sample item

A newborn with bilious vomiting is found to have a jejunoileal atresia in which the distal ileum spirals around a single mesenteric vessel in an apple-peel pattern. What is the cause?

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

The answer and the reasoning

D. Intrauterine vascular occlusion of the superior mesenteric artery branch

Jejunoileal atresia, unlike duodenal atresia, is explained by a late intrauterine mesenteric vascular accident, and the apple-peel (type IIIb) form lacks the distal superior mesenteric artery. Duodenal atresia is caused by failure of recanalisation. Treatment is resection of the atretic ends with anastomosis, and short bowel risk is considered.

Option by option

  • A. Aganglionosis

    Aganglionosis causes Hirschsprung disease.

  • B. Meconium plug

    Meconium plug is a functional obstruction.

  • C. Failure of recanalisation of the duodenum

    Failure of recanalisation explains duodenal atresia.

  • D. Intrauterine vascular occlusion of the superior mesenteric artery branch (correct)

    Correct. A vascular insult causes jejunoileal 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 General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Intrauterine vascular occlusion of the superior mesenteric artery branch. Jejunoileal atresia, unlike duodenal atresia, is explained by a late intrauterine mesenteric vascular accident, and the apple-peel (type IIIb) form lacks the distal superior mesenteric artery.

Why is "Aganglionosis" not the answer?

Aganglionosis causes Hirschsprung disease.

Why is "Meconium plug" not the answer?

Meconium plug is a functional obstruction.

Why is "Failure of recanalisation of the duodenum" not the answer?

Failure of recanalisation explains duodenal atresia.

What concept does this question test?

It tests Paediatric surgery: jejunoileal atresia in General Surgery. Duodenal atresia is caused by failure of recanalisation. Treatment is resection of the atretic ends with anastomosis, and short bowel risk is considered.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: jejunoileal atresia?

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.