Statistics from Altmetric.com
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 with surgical pathology from those without. It is probably unsurprising that an abnormal abdominal X-ray is strongly associated with surgical pathology. Indeed, many of the conditions reported in this study are associated with characteristic abdominal X-ray findings that …
Competing interests None.
Provenance and peer review Commissioned; externally peer reviewed.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.