<prompt> Which one of the following is most suggestive of neonatal small bowel obstructionGeneralized abdominal distensionFailure to pass meconeum in the first 24 hoursBilious vomitingRefusal of feeds  <response>: Bilious vomiting is the most common symptom. InternetIntestinal obstruction in the newborn Presentation depends on the site of obstruction.1. Proximal obstructionA history of polyhydramnios is common.The higher the obstruction in the intestine the earlier the infant will develop vomiting which may be bile stained.Abdominal distension will be less prominent.Obstipation is less common.2. Distal obstructionAbdominal distension and obstipation are more common.Vomiting is less common.Note -In neonates proximal intestinal obstruction is much more common than distal. So, bilious vomiting is the most common presentation of neonatal intestinal obstruction. 