skip to main content

NEC – perforation — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardNeonatalNEC – perforationRACP Paediatrics

A premature infant being treated for NEC develops sudden clinical deterioration with abdominal wall erythema, metabolic acidosis, and thrombocytopenia. Abdominal X-ray shows pneumoperitoneum (free intraperitoneal air). What is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Surgical consultation for laparotomy

Pneumoperitoneum indicates bowel perforation, which is an absolute indication for surgical intervention (laparotomy or peritoneal drain placement in extremely premature/unstable infants). This is a surgical emergency. The infant should be resuscitated and stabilised while surgical consultation is obtained urgently.

Reference: RCH Melbourne – 2023 – Necrotising Enterocolitis CPG; RACP Paediatric Curriculum – Neonatology