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Necrotising enterocolitis — RACP Paediatrics MCQ

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HardNeonatologyNecrotising enterocolitisRACP Paediatrics

A 9-day-old infant born at 28 weeks develops temperature instability, increasing apnoeas and abdominal distension. The nasogastric aspirates are bile stained and a small amount of fresh blood is seen in the stool. Abdominal radiograph shows bubbly lucencies within the bowel wall. What is the most likely diagnosis?

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Correct answer: D — Necrotising enterocolitis

Necrotising enterocolitis is suggested by prematurity, systemic instability, bloody stool and pneumatosis intestinalis. Spontaneous perforation may present with free air but typically lacks the inflammatory bowel-wall gas pattern. The key discriminator is pneumatosis in a vulnerable preterm infant with evolving sepsis.

Reference: RCH Necrotising enterocolitis guideline; RACP Knowledge Guides