A 42-year-old woman presents to the emergency department in active labor. She has had no prenatal care and is unsure of the gestational age. Labor progresses rapidly and spontaneous vaginal delivery of a baby boy occurs 3 hours after presentation. On initial exam, the child is 1.9 kg (4.2 lb) with a small head and jaw. A sac-like structure containing intestine, as can be seen in the picture, protrudes from the abdominal wall. What complication is closely associated with this presentation?
ALack of abdominal wall muscles
BDehydration and necrosis of bowel
CDuodenal atresia
DTwisting of the bowel around itself
ECardiac defect
A new mother expresses her concerns because her 1-day-old newborn has been having feeding difficulties. The child vomits after every feeding and has had a continuous cough since shortly after birth. The mother denies any greenish coloration of the vomit and says that it is only composed of whitish milk that the baby just had. The child exhibits these coughing spells during the exam, at which time the physician notices the child’s skin becoming cyanotic. The mother states that the child was born vaginally with no complications, although her records show that she had polyhydramnios during her last ultrasound before the delivery. Which of the following is the most likely cause of the patient’s symptoms?
AFailure of recanalization of duodenum
BObstruction due to failure of rotation of pancreatic tissue
CHypertrophy of the pyloric sphincter
DFailure of neural crest cells to migrate into the myenteric plexus
EDefective formation of the esophagus with tracheoesophageal connection
A 5-week-old male infant is brought to the physician by his mother because of a 4-day history of recurrent nonbilious vomiting after feeding. He was born at 36 weeks' gestation via spontaneous vaginal delivery. Vital signs are within normal limits. Physical examination shows a 2-cm epigastric mass. Further diagnostic evaluation of this patient is most likely to show which of the following?
ADilated colon segment on abdominal x-ray
BElongated and thickened pylorus on abdominal ultrasound
CDouble bubble sign on abdominal x-ray
DHigh serum 17-hydroxyprogesterone concentration
ECorkscrew sign on upper gastrointestinal contrast series
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