A 2-month-old female is brought to the emergency room (ER) for persistent bile-stained vomiting after feeding. Physical examination reveals dehydration, and x-ray reveals gas bubbles in the in-testines. What is the most likely cause of this condition?
a. Malrotation
b. Ileocecal displacement
c. Pyloric stenosis
d. Meconium ileus
ANS: A
In infants, malrotation obstruction causes intermittent or persistent bile-stained vomiting after feedings. Radiographic films of the abdomen and barium studies show intestinal gas bubbles and distention proximal to the site of obstruction. This assessment data does not support a diagnosis of ileocecal displacement. Pyloric stenosis is manifested by vomiting, but it is not bile stained and the colon is not displaced. In meconium ileus, there is an intestinal obstruction caused by meco-nium formed in utero.
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