A. Intussusception

B. Acute appendicitis

C. Malrotation with volvulus

D. Hypertrophic pyloric stenosis

E. Jejunal atresia

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The correct answer is C.

• When you see the sudden onset of green, bilious vomiting and blood per rectum in neonates, think of malrotation with volvulus. Also note the abdominal x-ray result "double bubble sign".

Why not Intussusception ?

• Intussusception is uncommon in neonates and would most likely occur in infants 6 months or older.

Why Hypertrophic pyloric stenosis?

• Pyloric stenosis would have projectile vomiting as a key feature and the age would be older than 3 weeks.

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