Approach to the Baby with Bilious Vomiting

Bilious vomiting in the term neonate is a cardinal feature of a critical condition – intestinal malrotation – and may herald an impending abdominal crisis. It may also be due to a number of other surgical and medical causes, and there is a significant healthcare burden in excluding malrotation in the neonatal population. Health professionals caring for neonates need a sound knowledge of the assessment, diagnosis, and management of the neonate presenting with bilious vomiting. This review discusses the approach and immediate management, discusses uncertainties in evidence and offers practical advice for healthcare professionals who are faced with a baby with bilious vomiting.