What symptoms are indicative of a neonate likely experiencing malrotation with volvulus?

The symptoms indicative of a neonate likely experiencing malrotation with volvulus prominently include green, bilious vomiting and blood per rectum. This presentation arises due to the twisting of the intestines that may obstruct normal intestinal flow, preventing the passage of bile and leading to green vomitus. The presence of bilious vomiting is particularly significant as it suggests that the contents of the small intestine, including bile, are being regurgitated, which is a concerning sign in neonates.

The blood per rectum may occur due to ischemia and necrosis of the intestinal tissue caused by compromised blood flow, a complication that can arise from volvulus as the blood supply to segments of the bowel is cut off. Therefore, the combination of green, bilious vomiting along with the possibility of rectal bleeding serves as a critical clinical alert for a possible surgical emergency in neonates, necessitating immediate evaluation and intervention.

Other options, while they may present in various conditions affecting neonates, do not strongly point to malrotation with volvulus. For example, while vomiting without diarrhea can occur, it is not specific to this condition. Persistent hiccups and irritability might suggest gastrointestinal distress but lack the specificity needed for diagnosing malrotation with volvulus. Similarly, decreased appetite