How should the neonatal retrieval team respond to the neonate referred with bilious vomiting?

2021 ◽  
Author(s):  
Sunaina Nundeekasen ◽  
Hannah Dalrymple ◽  
Ahmed Moustafa ◽  
Gordon Thomas ◽  
Kathryn Browning Carmo
Keyword(s):  
Bilious Vomiting ◽  
Retrieval Team

Outcomes of full-term infants with bilious vomiting: observational study of a retrieved cohort

2014 ◽  
Vol 100 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Syed Mohinuddin ◽  
Pankaj Sakhuja ◽  
Benjie Bermundo ◽  
Nandiran Ratnavel ◽  
Stephen Kempley ◽  
...  
Keyword(s):  
Posterior Probability ◽  
Abdominal Distension ◽  
Clinical Findings ◽  
Likelihood Ratios ◽  
Term Infants ◽  
X Ray ◽  
Bilious Vomiting ◽  
Term Newborns ◽  
Time Critical ◽  
Surgical Condition

Bilious vomiting in a neonate may be a sign of intestinal obstruction often resulting in transfer requests to surgical centres. The aim of this study was to assess the use of clinical findings at referral in predicting outcomes and to determine how often such patients have a time-critical surgical condition (eg, volvulus, where a delay in treatment is likely to compromise gut viability).Methods4-year data and outcomes of all term newborns aged ≤7 days with bilious vomiting transferred by a regional transfer service were analysed. Specificity, sensitivity, likelihood ratios, correlations, prior and posterior probability of clinical findings in predicting newborns with surgical diagnosis were calculated.ResultsOf 163 neonates with bilious vomiting, 75 (46%) had a surgical diagnosis and 23 (14.1%) had a time-critical surgical condition. The diagnosis of a surgical condition in neonates with bilious vomiting was significantly associated with abdominal distension (χ2=5.17, p=0.023), abdominal tenderness (χ2=5.90, p=0.015) and abnormal abdominal X-ray findings (χ2=5.68, p=0.017) but not with palpation findings of a soft as compared with a tense abdomen (χ2=3.21, p=0.073). Abnormal abdominal X-ray, abdominal distension and tenderness had 97%, 74% and 62% sensitivity, respectively, with regard to association with an underlying surgical diagnosis. Normal abdominal X-ray reduced the posterior probability of surgical diagnosis from 50% to 16%. Overall, clinical findings at referral did not differentiate between infants with or without surgical or time-critical condition.ConclusionsWe recommend that term neonates with bilious vomiting referred for transfer are prioritised as time critical.

Low incidence of surgical pathology in infants with bilious vomiting

2021 ◽  
Author(s):  
David Andrew Cummins ◽  
Carl Kuschel
Keyword(s):  
Imaging Study ◽  
Hirschsprung Disease ◽  
Abdominal Distension ◽  
Surgical Pathology ◽  
Term Infants ◽  
Term Neonates ◽  
Bilious Vomiting ◽  
Highly Sensitive ◽  
Abdominal Radiographs ◽  
Low Incidence

Abstract Background: Bilious vomiting in the neonate is an important presenting sign of intestinal obstruction. We conducted a review of the presentation and management of term neonates admitted with bilious vomiting (BV) to determine the incidence of a surgical pathology in our population.  Design: Retrospective cohort study using a prospectively maintained database.  Participants: All term infants admitted to NICU with BV at the Royal Women’s Hospital Melbourne during a 5-calendar year period.  Results: All 153 babies had at least one imaging study. 128 (83.7%) had plain abdominal radiographs. 127 (83%) underwent upper gastrointestinal contrast scan (UGI) and 103 (67.3%) had both. 6 (3.9%) UGI studies were abnormal, with 3 babies (1.9%) subsequently having surgical pathology (2 volvulus, 1 Hirschsprung disease). Only 6 (3.9%) babies in our cohort had a surgical pathology identified (4 Hirschsprung disease, 2 malrotation). Babies with surgical pathology were more likely to present later (median 40 hours versus 23 hours). Abdominal distension was highly sensitive for surgical pathology.  Conclusion: The incidence of surgical pathology in this cohort was low compared to other studies. It is more likely in infants presenting with BV after 24 hours. 

Risk Factors of Operation in Neonates with No Less Than 35 Weeks of Gestational Age with Bilious Vomiting

Perinatology ◽  
2016 ◽  
Vol 27 (4) ◽  
pp. 216
Author(s):  
Jae Seok Shin ◽  
Yong Hee Lee ◽  
Gyu Hong Shim ◽  
Myoung Jae Chey
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
Bilious Vomiting

scholarly journals Diagnostic Accuracy of Ultrasound in Determining the Cause of Bilious Vomiting in Neonates

2012 ◽  
Vol 9 (4) ◽  
pp. 190-4 ◽  
Author(s):  
Mehdi Alehossein ◽  
Siamak Abdi ◽  
Mohammad Pourgholami ◽  
Mohsen Naseri ◽  
Payman Salamati
Keyword(s):  
Diagnostic Accuracy ◽  
Bilious Vomiting
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