A premature neonate on top feeding develop abdominal destension and bleeding per rectum. He recently recovered from acute upper respiratory tract infection. What is the probable diagnosis: (A) Necrotizing enterocolitis, (B) Valvulus, (C) Meckel's diveiculum, (D) Intussusception
Answer is A. .Necrotising enterocoilitis occurs among premature infants under stress in first week of life. pathogenesis:mucosal injury, bacterial infections of the injured gut with E.colli,,Klebsiella,Pseudomonas ,Clostridia, Salmonella,formula feeding clinical features: stage 1:unstable temperature,apnea,lethargy,mild abdominal distension,vomiting, in stage 1B ,blood is present in stools stage 2:clinical signs as above,bowel sounds are diminished,tenderness may be present.In 2B there may be metabolic acidosis and thrombocytopenia. Stage 3:above features+low BP,bradycardia,apnea,acidosis,DIC,even anuria ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:139, 7th edition