[cerebrum85]

When you see the word Bilious (greenish) vomiting in Neonate...think of the following:

• Duodenal atresia
• Meconium ileus
• Meconium plug

Feel free to add to the list

 

[tkourkou]

The list seems full! Thanks DrCerebrum

And may I add just for fun that a cause of bilious vomiting is a color-blind physician watching a bloody vomit!

 

[1TA2B]

would be good to hear from Dr Cereburm how to differentiate between them! Thanks

 

[pkul85]

Duodenal Atresia- look for : premature baby, down syndrome, polyhydramnios on prenatal exam. Also search for other VACTREL associations as well as "double bubble " on CXR. ( ofcourse double bubble is not specific for duodenal atresia)

Meconium plugs- look for patients with history of : small left colon ( seen in infants of diabetic mothers), hirschprung disease, CF, maternal drug abuse.

Meconium Ileus- rule out cystic fibrosis.

Abdominal XR for meconium plugs and ilenus- multiple dilated loops of bowel, ground glass appearance in lower abdomen.

* corrections, additions are welcome !* Sorry for any errors

 

[singhmd]

what about malrotation??

 

[mohsinhamid]

Jejunal atresia also has bilous vomiting

 

[giovanni83]

any

I think that any kind of obstruction below the pylorus can give a bilious vomiting in neonate...

The main think is that when you see a greenish vomiting: start thinking about something serious...

Instead if it was not bilious (aka not greenish) could also be normale GERD of neonate.

 

[mindhunter2850]

Some More

Also,

- Malrotation
- Midgut Volvulus (Corkscrew Appearance on Barium Upper GI series)
- Intususception (with current jelly stools and target sign on USG)
- Jejunal Atresia (Triple Bubble on Abd. X-ray)