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Bilious vomiting during the first week of life
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi [Journal]. Zhonghua Minguo Xiao Er Ke Yi Xue Hui
|May 1, 1994
Summary
Bilious vomiting in newborns often requires surgery, but clinical signs like abdominal distension and tenderness are key indicators. Plain abdominal X-rays are crucial for differentiating surgical from nonsurgical infant conditions.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Diagnostic Imaging
Background:
- Bilious vomiting in newborns is a critical sign requiring prompt evaluation.
- Distinguishing between surgical and nonsurgical causes is essential for timely intervention.
Purpose of the Study:
- To evaluate clinical findings and plain abdominal roentgenograms in identifying the need for surgical intervention in newborns with bilious vomiting.
- To determine the diagnostic utility of initial imaging in neonates presenting with vomiting.
Main Methods:
- Prospective study of 45 newborns admitted with bilious vomiting within the first 7 days of life.
- Analysis of clinical signs (vomiting, abdominal distension, tenderness, lethargy, irritability) and plain abdominal roentgenograms.
- Correlation of findings with the need for surgical intervention.
Main Results:
- Twenty-three infants (51.1%) required surgery; 22 (48.9%) had nonsurgical conditions.
- Green vomitus, abdominal distension, lethargy, irritability, and tenderness suggested surgical need.
- Onset of vomiting and first stool passage were not predictive of surgical necessity.
- Plain abdominal roentgenograms were helpful; 16 infants with normal X-rays had nonsurgical conditions.
- Specific roentgenogram findings were present in 23 infants, 19 (82.6%) of whom required surgery.
Conclusions:
- Clinical signs like abdominal distension and tenderness are important indicators for surgical intervention in neonates with bilious vomiting.
- Plain abdominal roentgenograms are valuable in differentiating surgical from nonsurgical infant conditions, with specific findings often necessitating surgery.