<prompt> Which one of the following is most suggestive of neonatal small bowel obstruction:Generalized abdominal distensionFailure to pass meconium in the first 24 hoursBilious vomitingRefusal of feeds  <response>: Bilious vomiting is the most common symptom of intestinal obstruction in newborn Proximal obstruction- history of polyhydramnios is common Obstruction high in the intestinal tract results in frequent, bilious emesis with little or no abdominal distention. Distal obstruction- Abdominal distension and constipation are more common, while vomiting is less common. In neonates proximal intestinal obstruction are more common. So, bilious vomiting is the most common presentation of neonatal intestinal obstruction. 