Question:
Which of the following is NOT a part of the classical triad of necrotizing enterocolitis (NEC)?
Which of the following is NOT a part of the classical triad of necrotizing enterocolitis (NEC)?
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Classical Triad of Necrotizing Enterocolitis (NEC):
1. Abdominal distension
2. Feeding intolerance (bilious aspirates/emesis)
3. Hematochezia (blood in stool)
X-ray hallmark: Pneumatosis intestinalis (air in bowel wall).
1. Abdominal distension
2. Feeding intolerance (bilious aspirates/emesis)
3. Hematochezia (blood in stool)
X-ray hallmark: Pneumatosis intestinalis (air in bowel wall).
Updated On: Sep 3, 2026
- Abdominal distension
- Feeding intolerance
- Hypoglycemia
- Blood in stool
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The Correct Option is C
Solution and Explanation
Concept:
Necrotizing Enterocolitis (NEC) is the most common life-threatening gastrointestinal emergency encountered in premature and low-birth-weight neonates.
It results from an interplay of intestinal mucosal immaturity, formula feeding, ischemic-reperfusion injury, and aberrant bacterial colonization, leading to transmural bowel necrosis.
Explanation:
• The classical clinical triad describing the initial gastrointestinal manifestation of NEC comprises:
1. Abdominal distension (due to ileus, intestinal dilation, and wall inflammation).
2. Feeding intolerance bilious gastric residuals vomiting.
3. Blood in stools (either gross hematochezia or occult blood detected on testing).
• Abdominal distension is often the earliest and most reliable clinical physical sign of evolving enterocolitis.
• Feeding intolerance manifests as increasing pre-feed aspirates containing undigested milk or bilious material alongside recurrent emesis.
• Bloody stools arise from mucosal ulceration, microvascular thrombosis, and sloughing of ischemic intestinal mucosa.
• While systemic instability in NEC can cause temperature instability, lethargy, apnea, or metabolic acidosis, hypoglycemia is NOT considered a defining component of the classical clinical triad.
• The pathognomonic radiologic sign on abdominal X-ray remains pneumatosis intestinalis (gas within the bowel wall) and portal venous gas.
Final Answer:
Hypoglycemia is a non-specific systemic sign and is not a part of the classical diagnostic triad of necrotizing enterocolitis.
Necrotizing Enterocolitis (NEC) is the most common life-threatening gastrointestinal emergency encountered in premature and low-birth-weight neonates.
It results from an interplay of intestinal mucosal immaturity, formula feeding, ischemic-reperfusion injury, and aberrant bacterial colonization, leading to transmural bowel necrosis.
Explanation:
• The classical clinical triad describing the initial gastrointestinal manifestation of NEC comprises:
1. Abdominal distension (due to ileus, intestinal dilation, and wall inflammation).
2. Feeding intolerance bilious gastric residuals vomiting.
3. Blood in stools (either gross hematochezia or occult blood detected on testing).
• Abdominal distension is often the earliest and most reliable clinical physical sign of evolving enterocolitis.
• Feeding intolerance manifests as increasing pre-feed aspirates containing undigested milk or bilious material alongside recurrent emesis.
• Bloody stools arise from mucosal ulceration, microvascular thrombosis, and sloughing of ischemic intestinal mucosa.
• While systemic instability in NEC can cause temperature instability, lethargy, apnea, or metabolic acidosis, hypoglycemia is NOT considered a defining component of the classical clinical triad.
• The pathognomonic radiologic sign on abdominal X-ray remains pneumatosis intestinalis (gas within the bowel wall) and portal venous gas.
Final Answer:
Hypoglycemia is a non-specific systemic sign and is not a part of the classical diagnostic triad of necrotizing enterocolitis.
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