A 3-Week-Old-Girl in the Neonatal Intensive Care Unit Develops Abdominal

A 3-week-old-girl in the neonatal intensive care unit develops abdominal distension, vomiting, and blood-streaked stools.  She had previously tolerated formula feeds and had normal stool and urine output.  She was born at 27 weeks gestation to an 18-year-old-mother.  The pregnancy was complicated by premature rupture of membranes and preterm delivery.  Abdominal x-ray shows thin curvilinear areas of lucency that parallel the bowel wall lumen.  Which of the following is the most likely diagnosis?

A) Duodenal atresia
B) Hirschsprung disease
C) Malrotation with volvulus
D) Necrotizing enterocolitis
E) Pyloric stenosis

Correct Answer:

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