Which one of the following is most suggestive of neonatal small bowel obstruction -
Generalized abdominal distension
Failure to pass meconeum in the first 24 hours
Bilious vomiting
Refusal of feeds
Ans. is 'c' i.e., Bilious vomiting "Bilious vomiting is the most common symptom". -- Internet Intestinal obstruction in newborn Presentation depends on the site of obstruction. 1. Proximal obstruction o A history ofpolyhydramnios is common. o The higher the obstruction in the intestine the earlier the infant will develop vomiting which may be bile stained. o Abdominal distension will be less prominent. o Obstipation is less common. 2. Distal obstruction o Abdominal distension and obstipation are more common. o Vomiting is less common. Note ? In neonates proximal intestinal obstruction are much more common than distal. So, bilious vomiting is the most common presentation of neonatal intestinal obstruction.