What x-ray finding is often seen in cases of NEC?

The soap-bubbly appearance of the bowel is a classic x-ray finding in cases of necrotizing enterocolitis (NEC). This appearance arises due to the presence of intramural air or gas within the bowel wall, which results from the breakdown of the intestinal mucosa and potentially leads to peritonitis. In infants with NEC, the damaged bowel can become necrotic, allowing gas to form within the tissue, which contributes to the characteristic "bubbly" appearance observed on radiographic imaging. Identifying this radiological sign is crucial for early diagnosis and management of NEC, as the condition can progress rapidly and is associated with significant morbidity and mortality in neonates.

The other choices do not specifically correlate with NEC. An air-filled stomach can be a common finding in many conditions and is not unique to NEC. Excessive air in the lungs is often indicative of respiratory issues such as pneumothorax or respiratory distress syndrome, rather than gastrointestinal pathology. An enlarged heart shadow could suggest cardiac enlargement or fluid overload, which is unrelated to the intestinal necrosis seen in NEC. Thus, the soap-bubbly appearance of the bowel stands out as the definitive x-ray finding associated with this serious condition.