12th May 2024

A 3-week-old premature infant, born at 32 weeks gestation, is admitted to the neonatal intensive care unit with abdominal distension, vomiting, and bloody stools.

A 3-week-old premature infant, born at 32 weeks gestation, is admitted to the neonatal intensive care unit with abdominal distension, vomiting, and bloody stools. The infant was recently started on enteral feedings. An abdominal X-ray reveals pneumatosis intestinalis. Laboratory tests show an elevated white blood cell count and metabolic acidosis.

Which underlying mechanism is most likely responsible for this infant’s clinical presentation?