This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
Which one of the following is most suggestive of neonatal small bowel obstruction – 
Select and explain. 
A. Generalized abdominal distension, B. Failure to pass meconeum in the first 24 hours, C. Bilious vomiting, D. Refusal of feeds
C: Bilious vomiting
Answer: C: Bilious vomiting 
Explanation: "Bilious vomiting is the most common symptom".  — Internet
Intestinal obstruction in the newborn 
Presentation depends on the site of obstruction.
1. Proximal obstruction

A history of polyhydramnios is common.
The higher the obstruction in the intestine the earlier the infant will develop vomiting which may be bile stained.
Abdominal distension will be less prominent.
Obstipation is less common.


2. Distal obstruction

Abdominal distension and obstipation are more common.
Vomiting is less common.

Note -

In neonates proximal intestinal obstruction is much more common than distal. So, bilious vomiting is the most common presentation of neonatal intestinal obstruction.