An abdominal series is ordered. In the meantime, his mother is observed feeding him with a bottle and he is noted to feed very well. The CBC done at the rural E.D. is normal. His hemoglobin is 17.3, hematocrit 49.6. A repeat of his hemogram shows Hgb 17.2, Hct 50.3.
Coagulation studies are normal.
A urine toxicology screen on the infant is negative. An Apt test done on the hematemesis residue on the blanket is negative for fetal hemoglobin indicating that the blood on the blanket did not come from the infant. The abdominal series is cancelled. NEC presents in the neonatal period with signs and symptoms that include guaiac positive stool, poor feeding, vomiting, hematemesis, abdominal distention, abdominal discoloration, abdominal tenderness, bowel obstruction, or other findings suggestive of an acute abdomen. Premature infants are at highest risk.