A 3-Day-Old Boy Is Brought to the Emergency Department Due

question 4

Multiple Choice

A 3-day-old boy is brought to the emergency department due to poor feeding, emesis, and lethargy over the last 24 hours.  The patient was born via uncomplicated spontaneous vaginal delivery to a 30-year-old woman who had a normal pregnancy.  The boy was discharged from the newborn nursery yesterday and was breastfeeding exclusively until the onset of symptoms.  Stool and urine output were normal while he was in the newborn nursery.  The patient is afebrile and normotensive but tachycardic and tachypneic.  He appears dehydrated, and the abdomen is distended.  The patient vomits during the examination, and the vomitus is shown in the exhibit.

On laparotomy, fibrous bands are seen extending from the cecum and right colon to the retroperitoneum, causing extrinsic compression of the duodenum.  Which of the following embryologic processes most likely failed in this patient?

• A)Failure of gut recanalization
• B)Fusion of the ventral and dorsal pancreatic buds
• C)Midgut rotation around the superior mesenteric artery
• D)Neural crest cell migration into the bowel wall
• E)Obliteration of the omphalomesenteric duct

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Definitions:

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