A 2-day-old newborn has green (bilious) vomiting and a distended upper abdomen. What is the priority?
Answer and explanation
Correct answer: B. Resuscitate, place a nasogastric tube and arrange urgent surgical assessment for malrotation with volvulus
- Step 1: Bilious vomiting in a newborn is a surgical emergency until proven otherwise. Step 2. Malrotation with midgut volvulus can cause bowel necrosis within hours, so surgical review and imaging are urgent. Answer: Resuscitation and urgent surgical assessment. Why not the others: Bilious vomiting is never normal. Changing formula and oral antibiotics delay diagnosis.
Practise more Surgery and Emergency Medicine.
Free questions with an explanation for every one, and full timed ENAM Practice (Peru National Medical Examination) mock tests.
More Surgery and Emergency Medicine questions
- A 19-year-old has abdominal pain that began around the umbilicus and moved to the right iliac fossa over twelve hours, with anorexia. What i…
- McBurney's point lies at which position?
- Which investigation is first line for suspected acute cholecystitis?
- A man has fever, jaundice and right upper quadrant pain (Charcot triad). What is the most likely diagnosis?
- A 66-year-old has right upper quadrant pain, fever, jaundice, blood pressure 85/50 mmHg and new confusion. What is the best management plan?
- What is the commonest cause of small bowel obstruction in an adult who had previous abdominal surgery?