A 26-week preterm infant (birth weight 800 g) develops bloody stools, abdominal distension, and pneumatosis intestinalis on abdominal X-ray at day 12 of life. The HALLMARK radiological finding that indicates intestinal wall necrosis in this condition is:
- A Gasless abdomen
- B Pneumoperitoneum
- C Pneumatosis intestinalis (gas within bowel wall) ✓
- D Double bubble sign
Correct answer: C. Pneumatosis intestinalis (gas within bowel wall)
Explanation
Necrotizing enterocolitis (NEC) in preterm infants shows pneumatosis intestinalis — gas within the bowel wall produced by gas-forming bacteria — as the pathognomonic radiological finding indicating full-thickness intestinal wall involvement. Pneumoperitoneum (free air) indicates bowel perforation, requiring urgent surgical intervention (Stage IIIB Bell's criteria). The double bubble sign is characteristic of duodenal atresia, not NEC.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.