Black Stools in a Preterm: A Diagnostic Dilemma

Shweta Kumari Singh

Abstract: Background: Melena in newborn period is relatively uncommon but clinically significant presentation that requires prompt evaluation to rule out life - threatening causes. Case discussion: Here, we present a case of late preterm, small- for- gestational - age, low - birth - weight male infant, born through meconium - stained liquor, who had multiple episodes of bloody stool starting at 4 hours of life. The baby received 1mg of vitamin K at birth. He was admitted in newborn intensive care unit in view of respiratory distress, but had no signs of bleeding. Nasogastric tube aspiration was meconium - stained mixed with streaks of coffee - ground - color aspirate. At 14 hours of life, he developed anemia (10.9gm/dl) requiring one aliquot of packed red cell transfusion. Further workup was done to rule out life threatening conditions like sepsis, enterocolitis, coagulopathy and surgical causes. All investigations were normal. The baby remained clinically stable post transfusion. After 48 hours, his bloody stool stopped and he started passing greenish stools. He was discharged after five days. Further follow - up did not reveal any recurrence of bloody stools. Conclusion: In this case, the baby had evidence of perinatal stress, as indicated by the fetal tachycardia, meconium - stained liquor, metabolic acidosis at birth which may have been a risk factor for melena.

Keywords: melena, preterm newborn, bloody stools, perinatal stress

How to Cite?: Shweta Kumari Singh, "Black Stools in a Preterm: A Diagnostic Dilemma", Volume 15 Issue 9, September 2026, International Journal of Science and Research (IJSR), Pages: 102-104, https://www.ijsr.net/getabstract.php?paperid=SR26828165917, DOI: https://dx.doi.org/10.21275/SR26828165917

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