HY USMLE Q #1363 – Gastro

A 2-month-old newborn boy is brought to the emergency department due to persistent bilious vomiting and poor feeding. He was born at term via vaginal delivery without complications and had passed meconium within the first 24 hours. An abdominal x-ray shows dilated loops of small bowel with air-fluid levels. An upper GI series is shown. Which of the following is the most likely explanation for this patient’s presentation?

  Abnormal gut rotation
  Absence of enteric ganglion cells
  Defective recanalization of the duodenum
  Failure of the vitelline duct to obliterate
  Rotational and migrational abnormality of ventral pancreatic bud