Neonatology: necrotising enterocolitis: practice question

A Pediatrics 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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Pediatrics · Neonatology: necrotising enterocolitis

Sample item

A 28-week infant on enteral feeds develops abdominal distension and bloody stools on day 10. Which radiological finding is an absolute indication for surgery?

APneumatosis intestinalisBPneumoperitoneumCFixed dilated bowel loop onlyDPortal venous gas

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

The answer and the reasoning

B. Pneumoperitoneum

Free air under the diaphragm means bowel perforation, the clear indication for laparotomy or a peritoneal drain. Pneumatosis intestinalis is the diagnostic sign of necrotising enterocolitis and portal venous gas a severe sign, but both can be managed medically with bowel rest and antibiotics.

Option by option

A. Pneumatosis intestinalis
Pneumatosis confirms the diagnosis but can be treated medically.
B. Pneumoperitoneum (correct)
Correct. Pneumoperitoneum indicates perforation and requires surgical intervention.
C. Fixed dilated bowel loop only
A persistent fixed loop is a relative sign that prompts close review, not surgery by itself.
D. Portal venous gas
Portal venous gas indicates severe disease but is not an absolute indication.

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.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Pneumoperitoneum. Free air under the diaphragm means bowel perforation, the clear indication for laparotomy or a peritoneal drain.

Why is "Pneumatosis intestinalis" not the answer?

Pneumatosis confirms the diagnosis but can be treated medically.

Why is "Fixed dilated bowel loop only" not the answer?

A persistent fixed loop is a relative sign that prompts close review, not surgery by itself.

Why is "Portal venous gas" not the answer?

Portal venous gas indicates severe disease but is not an absolute indication.

What concept does this question test?

It tests Neonatology: necrotising enterocolitis in Pediatrics. Pneumatosis intestinalis is the diagnostic sign of necrotising enterocolitis and portal venous gas a severe sign, but both can be managed medically with bowel rest and antibiotics.

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 Neonatology: necrotising enterocolitis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.