A premature neonate at 28 weeks gestation develops abdominal distension, bloody stools, and thrombocytopenia on day 10 of life. Abdominal X-ray shows 'train-track' radiolucencies in the bowel wall. What is this radiological sign called?
- A Chilaiditi sign
- B Pneumatosis intestinalis ✓
- C Rigler sign
- D Football sign
Correct answer: B. Pneumatosis intestinalis
Explanation
Pneumatosis intestinalis — intramural gas within the bowel wall appearing as linear ('train-track') or bubbly lucencies — is pathognomonic of necrotizing enterocolitis (NEC) in premature neonates. Portal venous gas (branching lucencies in the liver) and pneumoperitoneum (free air) are more advanced signs indicating perforation. Rigler's sign is free air visible on both sides of the bowel wall (double-wall sign). The football sign is a large oval lucency from massive pneumoperitoneum in supine neonates.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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