Neonatal Intestinal Obstruction

Question 1

What is the definition of a neonate?

Answer 1

A child less than 4 weeks (28 days) old.

Question 2

What is the definition of neonatal intestinal obstruction?

Answer 2

A blockage in the intestinal tract preventing the forward movement of contents, mostly congenital.

Question 3

What maternal condition is commonly associated with neonatal intestinal obstruction?

Answer 3

Maternal polyhydramnios.

Question 4

What are common symptoms of neonatal intestinal obstruction?

Answer 4

Feeding intolerance, bilious emesis, abdominal distension, failure to pass meconium.

Question 5

What is the incidence of neonatal intestinal obstruction?

Answer 5

1 in 2,000 births.

Question 6

What chromosomal abnormality is duodenal atresia commonly associated with?

Answer 6

Trisomy 21 (Down syndrome) in 30% of cases.

Question 7

What does VACTERL syndrome stand for?

Answer 7

Vertebral, Anal, Cardiac, Tracheoesophageal, Renal, Limb anomalies.

Question 8

What is the most common cause of jejunal and ileal atresia?

Answer 8

Vascular accidents during fetal development.

Question 9

What are the three main mechanisms of neonatal intestinal obstruction?

Answer 9

Intraluminal, extramural, and intramural obstruction.

Question 10

What is an example of an intraluminal cause of obstruction?

Answer 10

Meconium plug.

Question 11

What is an example of an extramural cause of obstruction?

Answer 11

Ladd bands, Meckel’s diverticulum, hernias.

Question 12

What is an example of an intramural cause of obstruction?

Answer 12

Atresia, Hirschsprung disease.

Question 13

What is the characteristic radiologic sign of duodenal atresia?

Answer 13

Double bubble sign.

Question 14

What condition presents with difficulty swallowing and gastric vomiting in neonates?

Answer 14

Foregut obstruction.

Question 15

What condition presents with bilious vomiting and abdominal distension?

Answer 15

Jejunal or ileal obstruction.

Question 16

What are the three surgical procedures used to treat Hirschsprung disease?

Answer 16

Swenson, Duhamel, and Soave procedures.

Question 17

What is the most common cause of large bowel obstruction in neonates?

Answer 17

Hirschsprung disease (aganglionic megacolon).

Question 18

What diagnostic tool is useful for detecting hypertrophic pyloric stenosis?

Answer 18

Ultrasonography.

Question 19

What is the preferred non-surgical method for treating intussusception?

Answer 19

Air insufflation.

Question 20

What is the purpose of placing a nasogastric tube in neonatal intestinal obstruction?

Answer 20

To decompress the intestine.

Question 21

What contrast enema is used for both diagnosis and treatment of meconium ileus?

Answer 21

Gastrografin enema.

Question 22

What is the primary treatment for duodenal atresia?

Answer 22

Surgical correction.

Question 23

What is a hallmark feature of colonic obstruction in neonates?

Answer 23

Abdominal distension, feculent emesis, and failure to pass meconium.

Question 24

What condition presents with failure to pass meconium within 48 hours of birth?

Answer 24

Hirschsprung disease.

Question 25

What is the standard initial management for neonatal intestinal obstruction?

Answer 25

Admission, NG decompression, IV fluids, antibiotics, and respiratory/cardiac support.

Question 26

What type of biopsy is used for diagnosing Hirschsprung disease?

Answer 26

Rectal suction biopsy or full-thickness biopsy.

Question 27

What is the treatment for an imperforate anus?

Answer 27

Surgical incision and repair.

Question 28

What is the significance of a 'double bubble' sign on X-ray?

Answer 28

Suggests duodenal atresia.

Question 29

Which diagnostic imaging modality is most useful for malrotation with volvulus?

Answer 29

Upper GI series.

Question 30

What is the first-line imaging study for neonatal bowel obstruction?

Answer 30

Plain abdominal X-ray.

Question 31

Which condition involves the failure of neural crest cells to migrate to the colon?

Answer 31

Hirschsprung disease.

Question 32

What is the most common cause of lower gastrointestinal obstruction in neonates?

Answer 32

Hirschsprung disease.

Question 33

What condition is characterized by delayed passage of meconium and chronic constipation?

Answer 33

Hirschsprung disease.

Question 34

What is the treatment of choice for jejunal atresia?

Answer 34

Surgical relief of the obstruction.

Question 35

What is the prognosis for uncomplicated neonatal intestinal obstruction?

Answer 35

Generally good.

Question 36

What is the best initial step in managing meconium ileus?

Answer 36

Gastrografin enema.

Question 37

What can cause a closed-loop obstruction in neonates?

Answer 37

Volvulus or strangulated hernia.

Question 38

What does a 'soap bubble' appearance on X-ray suggest?

Answer 38

Meconium ileus.

Question 39

What percentage of neonates with intussusception respond to air insufflation?

Answer 39

0.83

Question 40

What condition is characterized by 'currant jelly' stools?

Answer 40

Intussusception.

Question 41

What is the most common location for neonatal small bowel atresia?

Answer 41

Jejunum and ileum.

Question 42

What is a key sign of an esophageal atresia with tracheoesophageal fistula?

Answer 42

Excessive drooling and respiratory distress.

Question 43

What syndrome is commonly associated with anal atresia?

Answer 43

VACTERL syndrome.

Question 44

What causes a meconium plug syndrome?

Answer 44

Functional immaturity of the colon.

Question 45

What surgical procedure is used for Hirschsprung disease before definitive pull-through?

Answer 45

Temporary colostomy.

Question 46

What is the most common surgical emergency in neonates?

Answer 46

Intestinal obstruction.

Question 47

What is the mortality risk of untreated neonatal intestinal obstruction?

Answer 47

High due to sepsis and shock.

Question 48

Which surgical technique for Hirschsprung disease preserves normal bowel function best?

Answer 48

Swenson procedure.

Question 49

What is the preferred surgical approach for duodenal atresia?

Answer 49

Duodenoduodenostomy.

Question 50

Why are multiple enemas sometimes needed for meconium ileus?

Answer 50

To loosen thick meconium with detergent-like effects.