A term, 3740-g newborn was admitted for suspected sepsis. Rupture of the membranes had occurred 18 hours prior to delivery and was associated with a maternal temperature of 38.1°C. Apgar scores were eight and nine at 1 and 5 minutes, respectively. A white blood cell count was 14.7 × 109/L, with the following differential cell count: polymorphonuclear cells, 0.16; band cells, 0.31; lymphocytes, 0.21; monocytes, 0.25; and eosinophils, 0.02. An admission blood culture was positive for group B Streptococcus. The infant received intravenous ampicillin and gentamicin.
The patient did well until the fourth day after birth when he developed bile-stained emesis. His temperature was 36.8°C. The heart rate was 131 beats per minute. Respirations were 52 per minute. The blood pressure was 77/61 mm Hg. The physical examination revealed a distended abdomen that was tender to palpation and moderately tense. Bowel sounds were hypoactive. The hematocrit was 0.40; the
Ruff ME, Southgate WM, Wood BP. Radiological Case of the Month. Am J Dis Child. 1991;145(1):111-112. doi:10.1001/archpedi.1991.02160010117029