Surgery · Pediatric Surgery

A premature neonate born at 28 weeks gestation develops abdominal distension, bloody stools, and lethargy on day 10 of life. Abdominal X-ray shows pneumatosis intestinalis. Bell stage classification is used to grade severity. Pneumatosis intestinalis corresponds to which Bell stage?

  • A Stage I (suspected NEC)
  • B Stage III (advanced NEC)
  • C Stage II (definite NEC)
  • D Stage IV (fulminant NEC)
Correct answer: C. Stage II (definite NEC)

Explanation

Bell stage II (definite NEC) is characterized by the presence of pneumatosis intestinalis or portal venous gas on abdominal X-ray, along with clinical features such as abdominal distension and bloody stools. Stage I is suspected with nonspecific signs. Stage III includes advanced disease with perforation or shock.

Reference: Neonatal Necrotizing Enterocolitis, Walker et al., referenced in Coran 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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