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The management of bilious vomiting in the neonate

D M Burge1

  • 1University of Southampton, UK; Department of Paediatric Surgery and Urology, Southampton Children's Hospital, Tremona Road, Southampton SO16 6YD, UK.

Early Human Development
|September 17, 2016
PubMed

Insights

Bilious vomiting in neonates indicates intestinal obstruction, often from congenital malformations or prematurity complications. Early diagnosis and management are crucial, especially excluding malrotation in term infants.

Area of Science:

  • Neonatal Medicine
  • Pediatric Surgery
  • Gastroenterology

Background:

  • Bilious vomiting in newborns is a critical sign of intestinal obstruction, either functional or anatomical.
  • Causes in neonates include congenital gastrointestinal malformations and acquired conditions, particularly in preterm infants.
  • Distinguishing between these causes presents significant diagnostic challenges.

Purpose of the Study:

  • To review congenital malformations causing bilious vomiting in neonates.
  • To explore diagnostic challenges in preterm infants with bilious vomiting.
  • To discuss the importance of excluding malrotation in term infants and the implications of transfer delays.

Main Methods:

  • Literature review of congenital gastrointestinal malformations presenting with bilious vomiting.
  • Analysis of diagnostic strategies for bilious vomiting in preterm neonates.
  • Discussion of malrotation diagnosis and management in term neonates.

Main Results:

  • Congenital malformations are a key cause of neonatal bilious vomiting.
  • Preterm infants present unique diagnostic difficulties.
  • Failure to exclude malrotation can have severe consequences.

Conclusions:

  • Bilious vomiting necessitates a thorough investigation for intestinal obstruction.
  • Prompt diagnosis and management are vital for optimal outcomes in neonates.
  • Careful evaluation for malrotation is critical in term infants presenting with these symptoms.

Keywords:
Intestinal obstructionNeonateSurgery

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