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Malrotation with Midgut Volvulus — RACP Paediatrics MCQ

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EasyGastroenterologyMalrotation with Midgut VolvulusRACP Paediatrics

A 2-month-old infant presents with sudden onset bilious vomiting. On examination, the abdomen is soft but the infant appears unwell. What is the most critical diagnosis to exclude?

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Correct answer: C — Malrotation with midgut volvulus

Bilious vomiting in a neonate or young infant is a surgical emergency until proven otherwise. Malrotation with midgut volvulus must be excluded urgently as delay leads to intestinal ischaemia and necrosis. An upper GI contrast study is the diagnostic investigation of choice. The infant requires urgent surgical assessment.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Bilious Vomiting in the Neonate