A 2-Day-Old Boy Develops Abdominal Distension and Refuses to Breastfeed

A 2-day-old boy develops abdominal distension and refuses to breastfeed.  He was born via normal spontaneous vaginal delivery at 39 weeks gestation to a primigravid mother.  Examination shows significant abdominal distension with palpable intestinal loops.  The rectum has no stool and rectal tone is normal.  During the examination, the infant has several episodes of dark green emesis.  Plain films of the abdomen show air-fluid levels and small bowel dilation.  Contrast enema fails to relieve the obstruction, and the patient is taken for emergency laparotomy, which shows an inspissated, green fecal mass obstructing the distal ileum.  The infant recovers from the surgery uneventfully.  Which of the following will be the most likely cause of mortality in this patient?

A) Enterocolitis
B) Liver cirrhosis
C) Malabsorption
D) Pneumonia
E) Renal failure

Correct Answer:

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