When a neonate has rectal bleeding it is essential to find the source and cause.
Risk factors to identify:
(1) prematurity
(2) presence of congenital malformations
(3) coagulopathy
(4) trauma
Conditions in which the neonate may be ill-appearing:
(1) necrotizing enterocolitis
(2) acute peptic ulceration
(3) Hirschsprung disease
(4) intestinal malrotation or intussusception
(5) ischemic bowel
Conditions in which the neonate may be miserable but does not look seriously ill:
(1) cow milk protein intolerance (if receiving cow's milk)
Conditions associated with an isolated anorectal disorder:
(1) anal fissure
(2) rectal prolapse
