An acquired disease that is primarily seen in preterm infants, characterized by feeding intolerance, bowel wall edema, and pneumatosis intestinalis is called:

• A. Necrotizing enterocolitis (NEC)
• B. Gastroesophageal reflux
• C. Meconium plug syndrome
• D. Malrotation

Answer: (A)

Necrotizing enterocolitis is an acquired inflammatory and necrotizing disease of the preterm gut. In these infants, feeding intolerance, abdominal distention, and bowel wall edema reflect evolving injury and inflammation of the immature intestine. The presence of pneumatosis intestinalis—gas within the bowel wall on imaging—is a hallmark finding and helps distinguish NEC from other neonatal GI issues. This condition arises from a combination of immature mucosal defense, altered intestinal perfusion, and abnormal bacterial colonization, leading to necrosis and potential perforation if not addressed.

Gastroesophageal reflux mainly causes spit-up and irritability, not bowel wall edema or gas within the intestinal wall. Meconium plug syndrome presents with distal obstruction due to a plug of meconium, not NEC. Malrotation typically causes bilious vomiting and possible intermittent obstruction rather than pneumatosis intestinalis.