menu ☰
menu ˟

Term newborns with bilious vomiting: When should they see a surgeon and how soon?

23 Oct 2014

It is surgical dogma that bilious (green) vomiting in the neonatal period is indicative of mechanical obstruction until proven otherwise. The proportion of babies with green vomiting who have a surgical cause for their symptoms is, however, well under 100%. Stringer in 2002 reported that bilious vomiting is, in fact, not caused by mechanical obstruction in 62% of patients.1

The work by Mohinuddin et al2 makes a useful contribution to our understanding of this subject. In this study, roughly half of term babies (46%), with bilious vomiting, transferred by the London Neonatal Transfer team for surgical assessment, had a surgical cause for this symptom. Fourteen per cent of babies in this study were found to have a time-critical diagnosis where a perforation was demonstrated or gut viability was potentially compromised.

This paper makes an important contribution by looking at whether clinical signs or X-ray findings can differentiate babies...

Click here to view the full article which appeared in Archives of Disease in Childhood