The diagnostic investigation for necrotising enterocolitis is an abdominal x-ray
The correct answer is an abdominal x-ray. This child is presenting with the signs and symptoms of necrotising enterocolitis. This condition has an unknown cause and is one of the leading causes of death among premature infants. It presents with abdominal distension, feeding intolerance and bloody stool. Additionally, the child can suffer from vomit bouts that are usually bilious. The x-ray will show dilated bowel loops, pneumatosis intestinalis (intramural gas) and occasionally portal venous gas. The treatment is with total gut rest and total parenteral nutrition, babies with perforations will require laparotomy.
Abdominal ultrasound is the investigation of choice for intussusception. This condition is characterised by paroxysmal abdominal colic pain and red currant jelly stool. The absence of these cardinal features makes this diagnosis unlikely.
Laparotomy is the investigation of choice in evident cases of perforation. In this case, the patient has no fever, making the diagnosis unlikely. Necrotising enterocolitis can eventually lead to perforation, so the child should be treated immediately to avoid so.
Test feed is used to diagnose pyloric stenosis. This condition is characterised by projectile vomiting, typically 30 minutes after a feed. Given that the child is presenting with generalised malaise and multiple gastrointestinal symptoms this diagnosis is unlikely.
An upper gastrointestinal tract contrast study is used to diagnose malrotation. This condition features exomphalos, congenital diaphragmatic hernia, intrinsic duodenal atresia. This child was born healthy making this diagnosis unlikely.
The correct answer is an abdominal x-ray. This child is presenting with the signs and symptoms of necrotising enterocolitis. This condition has an unknown cause and is one of the leading causes of death among premature infants. It presents with abdominal distension, feeding intolerance and bloody stool. Additionally, the child can suffer from vomit bouts that are usually bilious. The x-ray will show dilated bowel loops, pneumatosis intestinalis (intramural gas) and occasionally portal venous gas. The treatment is with total gut rest and total parenteral nutrition, babies with perforations will require laparotomy.
Abdominal ultrasound is the investigation of choice for intussusception. This condition is characterised by paroxysmal abdominal colic pain and red currant jelly stool. The absence of these cardinal features makes this diagnosis unlikely.
Laparotomy is the investigation of choice in evident cases of perforation. In this case, the patient has no fever, making the diagnosis unlikely. Necrotising enterocolitis can eventually lead to perforation, so the child should be treated immediately to avoid so.
Test feed is used to diagnose pyloric stenosis. This condition is characterised by projectile vomiting, typically 30 minutes after a feed. Given that the child is presenting with generalised malaise and multiple gastrointestinal symptoms this diagnosis is unlikely.
An upper gastrointestinal tract contrast study is used to diagnose malrotation. This condition features exomphalos, congenital diaphragmatic hernia, intrinsic duodenal atresia. This child was born healthy making this diagnosis unlikely.