All the following are features of neonatal necrotising enterocolitis EXCEPT –
**Core Concept**
Neonatal necrotizing enterocolitis (NEC) is a severe gastrointestinal disease that primarily affects premature infants. It involves ischemic injury and necrosis of the intestinal mucosa, which can lead to perforation and sepsis. The pathophysiology of NEC involves an imbalance between the intestinal microbiota and the host's immune response.
**Why the Correct Answer is Right**
The correct answer is one of the features that does not accurately describe neonatal NEC. NEC is characterized by:
* **Bowel wall thickening and gas within the bowel wall** due to ischemia and necrosis. This can be visualized on imaging studies such as X-rays or ultrasound.
* **Abdominal distension and tenderness**, which are clinical signs of bowel obstruction and peritonitis.
* **Laboratory evidence of sepsis**, such as elevated white blood cell count, C-reactive protein, and blood cultures positive for bacteria.
**Why Each Wrong Option is Incorrect**
**Option A:** This is incorrect because, although it is a feature of NEC, it is not the most specific or sensitive indicator of the disease. Other conditions can also present with abdominal distension and tenderness.
**Option B:** This is incorrect because, while it is a feature of NEC, it is not as specific as bowel wall thickening and gas within the bowel wall.
**Option D:** This is incorrect because it is not a feature of NEC. NEC is primarily a disease of the small and large intestine, not the stomach.
**Clinical Pearl / High-Yield Fact**
NEC is a leading cause of morbidity and mortality in premature infants. Early diagnosis and treatment are critical to prevent long-term sequelae and improve outcomes.
**Correct Answer:** D. This option is not a feature of neonatal necrotizing enterocolitis.