Question
Cause of “bloody” vomitus in a neonate –
| A. |
Meckel’s diverticulum |
| B. |
Intussusception |
| C. |
Malrotation |
| D. |
None |
Show Answer
|
Correct Answer » D Explanation |
 |
In a neonate, the most common cause of hematemesis (bloody vomiting) is swallowed maternal blood, either:
- During delivery, or
- From cracked maternal nipples during breastfeeding.
Since this option is not included, the correct answer is D. None of the above.
The Apt–Downey test is used to distinguish swallowed maternal blood from true neonatal gastrointestinal bleeding.
Why Other Options are Incorrect
A. Meckel’s diverticulum
- Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract.
- It usually presents with:
- Painless lower gastrointestinal bleeding (hematochezia or melena) due to ulceration from ectopic gastric mucosa.
- Intestinal obstruction.
- Diverticulitis.
- Although hematemesis has been reported rarely, it is not the typical presentation, especially not in the neonatal period.
- Symptomatic Meckel’s diverticulum most commonly presents in infants and young children rather than neonates.
B. Intussusception
- Rare in neonates.
- Classically presents with:
- Intermittent colicky abdominal pain.
- Vomiting.
- Red currant jelly stools.
- Hematemesis is uncommon.
C. Intestinal malrotation
- Typically presents with bilious vomiting in the neonatal period.
- Hematemesis is not the usual presentation and occurs only if bowel ischemia develops secondary to volvulus.
