Preterm Newborn With Abdominal Distention, Altered Nasogastric Aspirates, and Hematochezia

Abstract

A preterm newborn presents with abdominal distension, altered nasogastric aspirates, and hematochezia on day 11 after birth (Fig 1). Figure 1. ### Prenatal and Birth Histories: ### Presentation: The neonate was shifted to the neonatal intensive care unit (NICU) in view of prematurity/very low birthweight (1.285 kg) and begun on total parenteral nutrition according to unit protocol for absent end- diastolic flow (on antenatal Doppler ultrasonography). Expressed human milk was begun at 10 mL/kg per day after 48 hours of nil per os, and feedings were increased to 180 mL/kg per day by day 10 with vitamin D3 400 IU/day and human milk fortifier supplements with a calorie intake of 144 kcal/kg and protein intake of 3.2 g/kg. The neonate initially tolerated feedings well, with no abdominal distension or feed intolerance. The neonate was noted to have abdominal distension, altered nasogastric aspirates, and hematochezia on day 11 after birth. ### Vital Signs (Day 11)