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Newborn with abdominal distention
  1. Zemin Zhang,
  2. Guoqing Zhang,
  3. Chuanguang Zhang
  1. Weifang People's Hospital, Weifang, Shandong, China
  1. Correspondence to Dr Chuanguang Zhang, Weifang People's Hospital, Weifang, Shandong 261000, China; wfsrmyyzcg{at}163.com

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Clinical introduction

An 18-day-old male patient presented to the ED with a 2-day history of abdominal distension and blood in the faeces. The patient was born at 34 weeks. Meconium was passed within the first 24 hours. On physical examination, vital signs were normal. There was marked abdominal distention with dilated veins on the abdominal wall and bowel sounds quieter than usual. Abdominal radiography was performed (figure 1).

Figure 1

Abdominal radiograph.

Question

What is the most likely diagnosis?

  1. Necrotising enterocolitis

  2. Intussusception

  3. Meconium peritonitis

  4. Hirschsprung’s disease

Answer: A

Portal venous gas and pneumatosis intestinalis were present on radiographs (figure 2) which are characteristic imaging findings of neonatal necrotising enterocolitis …

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Footnotes

  • Handling editor Sarah Edwards

  • Contributors ZZ evaluated the patient at the ED and wrote the article. GZ was the operative surgeon and provided pictures and other materials. CZ curated and reviewed this article. All authors have read and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.