A premature neonate on top feeding develop abdominal distension and bleeding per rectum. He recently recovered from acute upper respiratory tract infection. What is the probable diagnosis ?
Ans. is 'a' i.e., Necrotizing enterocolitis This child is - i) Premature ii) On aificial feeding (top feeding) iii) Having abdominal distention and bleeding per rectum. o All these are suggestive of necrotizing enterocolitis :- i) The greatest risk factor for necrotizing enterocolitis is prematurity. ii) Almost all patients of neonatal enterocolitis are aificially fed prior to the onset of illness. In stage I, there is abdominal distention and blood in stool. So, the child in question is suffering from necrotizing enterocolitis. About other options o The hallmark of volvulus in neonatal period is bilious vomiting. o Intussusception presents between the age of 3-9 months (not in neonatal period). Symptoms of meckel diveiculum usually arise in the 1st 2 years of life (average 2.5 year) and most common presentation i4s painless rectal bleeding.
Necrotizing enterocolitis
Valvulus
Meckel's diveiculum
Intussusception