Bilious vomiting during the first week of life.

ABSTRACT

From Nov. 1988 to Nov. 1991, forty-five newborns, who were admitted due to bilious vomiting within the first 7 days of life followed prospectively. Twenty-three (51.1%) required surgical intervention, and the remaining twenty-two (48.9%) had nonsurgical conditions. Clinical findings of green vomitus, abdominal distension, lethargy, irritability and abdominal tenderness are more likely to indicate the need for surgery. But the onset of vomiting and time of first stool passage are not helpful in detecting the need for surgery situation. Initial routine plain abdominal roentgenogram is helpful in distinguishing infants with surgical or nonsurgical problems. Sixteen infants with normal plain abdominal roentgenograms had nonsurgical conditions. Specific findings on the plain abdominal roentgenogram were noted in 23 infants, and 19 (82.6%) of these needed surgical intervention. Contrast studies were indicated for those without signs of complete obstruction, perforation or peritonitis, but the plain abdominal roentgenogram was abnormal and clinical condition did not improved.