Paediatric surgery: stricture after necrotising enterocolitis: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric surgery: stricture after necrotising enterocolitis

Sample item

Six weeks after medical treatment of necrotising enterocolitis, a preterm infant develops vomiting and abdominal distension. A contrast study shows a short narrowed segment of the left colon with dilated bowel above it. What is the cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Post-inflammatory stricture

Strictures are the commonest late complication of NEC, occurring where ischaemic injury healed by fibrosis. The colon, especially the left side, is often involved. A contrast enema after recovery identifies it, and resection of the segment is usually needed.

Option by option

  • A. Post-inflammatory stricture (correct)

    Correct. Healing of ischaemic injury by fibrosis causes a stricture weeks after NEC.

  • B. Hirschsprung disease

    Hirschsprung disease presents with delayed meconium and a transition zone from birth, not a short focal stricture after NEC.

  • C. Meconium ileus

    Meconium ileus is a neonatal obstruction of cystic fibrosis in the terminal ileum and presents in the first days.

  • D. Malrotation with volvulus

    Malrotation with volvulus presents acutely with bilious vomiting and not with a localised colonic narrowing.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Post-inflammatory stricture. Strictures are the commonest late complication of NEC, occurring where ischaemic injury healed by fibrosis.

Why is "Hirschsprung disease" not the answer?

Hirschsprung disease presents with delayed meconium and a transition zone from birth, not a short focal stricture after NEC.

Why is "Meconium ileus" not the answer?

Meconium ileus is a neonatal obstruction of cystic fibrosis in the terminal ileum and presents in the first days.

Why is "Malrotation with volvulus" not the answer?

Malrotation with volvulus presents acutely with bilious vomiting and not with a localised colonic narrowing.

What concept does this question test?

It tests Paediatric surgery: stricture after necrotising enterocolitis in General Surgery. The colon, especially the left side, is often involved. A contrast enema after recovery identifies it, and resection of the segment is usually needed.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric surgery: stricture after necrotising enterocolitis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.