Bilious vomiting

Question 1

What is the presentation of NEC as a cause of bilious vomiting and how is it treated?

Answer 1

Premature neonate!

Dilated bowel loops on AXR

Conservative tx if non perforated
laparotomy if perforated

Question 2

What is the presentation of Duodenal atresia as a cause of bilious vomiting and how is it treated?

Answer 2

*down syndrome association

<6 hours after birth
Double bubble on AXR

Required duodenoduodenostomy

Question 3

What is the presentation of Jejunal/ileal atresia as a cause of bilious vomiting and how is it treated?

Answer 3

<24 hours of birth presenting

AXR for diagnosis

Requires laparotomy

Question 4

What is the presentation of Meconium ileus as a cause of bilious vomiting and how is it treated?

Answer 4

Associated with CF

24-48 hours after birth

Requires surgical decompression

Question 5

What is the presentation of malrotation volvulus as a cause of bilious vomiting and how is it treated?

Answer 5

3-7 days after birth

Upper GI contrast to show medial DJ flexure

Requires Ladd’s procedure