Bilious Vomiting Etiological Factors and Outcomes in Neonates of a Tertiary Care Hospital of Khyber Pukhtunkhwa, Peshawar; A Cross-sectional Study
DOI:
https://doi.org/10.70749/ijbr.v4i2.2764Keywords:
infant, bilious vomiting, etiology, frequency, ultrasonographyAbstract
Objective: Our study aims to determine the frequency of different causes of bilious vomiting in neonates and its outcomes in a tertiary care hospital of Peshawar. Methods: It was a cross-sectional study conducted in neonatology department of Lady Reading Hospital, Peshawar from 1st March, 2024 to 30th June, 2024. Neonates presenting with bilious vomiting to the nursery due to any etiology were included in the study. Data was collected from 66 neonates, by consecutive sampling technique with a semistructered questionnaire and after informed written consent by the parents. Data was collected regarding age of neonate in days, age, gender gestation, presence of sepsis. Maternal use of magnesium sulphate for pre-eclampsia if there was noted, thyroid Function tests of neonate. Radiological investigations done for the patients where indicated. Outcome of the neonates was noted as alive or expired. Data was analyzed using SPSS version 27. Descriptive statistics were performed for the categorical variables. And results were tabulated as frequencies and percentages. Results: Data was collected from 66 neonates. Full term neonates were 60 (90.9%) and 6 (9.1%) were preterm. Females were 26 (39.4%) and 40 (60.6%) of them were males. 56 (84.8%) presented within the first 10 days of life. The mean age was 1.17 days ± 0.4 (mean ± S.D. Surgery was performed in 58 (87.9%) of cases. Out of total 50 (75.8%) neonates were alive and 16 (24.2%) neonates expired. Among 47 (94%) neonates undergoing surgical management survived but 11 (68.8%) expired. Conclusion: Neonates presenting with bilious vomiting may have medical or surgical underlying etiology. Congenital gut atresias remain the leading cause of bilious vomiting in our setup. Among imaging modalities gastrointestinal contrast studies are superior in making diagnosis.
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References
1. Mohammad, S. A., Hamed, E. A., Shalaby, M. H., & Eldieb, L. M. (2020). Upper GI series in infants and children with vomiting: Insights into ACR appropriateness criteria. Egyptian Journal of Radiology and Nuclear Medicine, 51(1).
https://doi.org/10.1186/s43055-020-00289-w
2. Burge, D. (2016). The management of bilious vomiting in the neonate. Early Human Development, 102, 41-45.
https://doi.org/10.1016/j.earlhumdev.2016.09.002
3. Tullie, L. G., & Stanton, M. P. (2022). Bilious vomiting in the newborn. Surgery (Oxford), 40(11), 698-703.
https://doi.org/10.1016/j.mpsur.2022.09.005
4. Smith, K., Folaranmi, S. E., & Goel, N. (2022). Intestinal obstruction and ileus in the newborn. Paediatrics and Child Health, 32(1), 7-12.
https://doi.org/10.1016/j.paed.2021.10.003
5. Jackson, R., Folaranmi, S. E., & Goel, N. (2022). Approach to the baby with bilious vomiting. Paediatrics and Child Health, 32(1), 1-6.
https://doi.org/10.1016/j.paed.2021.10.009
6. Kimura, K., & Loening-Baucke, V. (2000). Bilious vomiting in the newborn: rapid diagnosis of intestinal obstruction. American family physician, 61(9), 2791-2798.
https://www.aafp.org/pubs/afp/issues/2000/0501/p2791.html
7. MOHAMED Y. BATIKHE, M. Z., & HISHAM ABDEL GHANY, A. A. (2020). Bile stained vomiting in neonates: Radiological and surgical correlation. The Medical Journal of Cairo University, 88(3), 649-660.
https://doi.org/10.21608/mjcu.2020.104619
8. Stephens, C., & O’connell, L. (2019). P475 Review of the management of bilious vomiting in term neonates and identify differences in management outside working hours in CUMH. Abstracts, A342.2-A343.
https://doi.org/10.1136/archdischild-2019-epa.811
9. Jones, J., Dixon, A., & Rasuli, B. (2012). Neonatal bilious vomiting. Radiopaedia.org.
https://doi.org/10.53347/rid-16977
10. Fullerton, L., Hussen, K., Mohinuddin, S., Sharif, S., Ragazan, J., Sinha, A., & Winn, R. (2023). 908 Can the colour of vomitus predict the outcomes of infants transferred with bilious vomiting? British Association of Perinatal Medicine and Neonatal Society, A168-A169.
https://doi.org/10.1136/archdischild-2023-rcpch.270
11. Choi, G., Je, B., & Kim, Y. J. (2022). Gastrointestinal emergency in neonates and infants: A pictorial essay. Korean Journal of Radiology, 23(1), 124.
https://doi.org/10.3348/kjr.2021.0111
12. Ratnayake, K., Kim, T. Y., Choi, S. J., & Jones, L. A. (2014). Evidence-based management of neonatal vomiting in the emergency department. Pediatric emergency medicine practice, 11(11), 1-20.
13. Sigmon DF, Eovaldi BJ, Cohen HL. Duodenal Atresia and Stenosis. 2023 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–.
14. Marine, M. B., & Karmazyn, B. (2014). Imaging of malrotation in the neonate. Seminars in Ultrasound, CT and MRI, 35(6), 555-570.
https://doi.org/10.1053/j.sult.2014.08.004
15. Nundeekasen, S., Dalrymple, H., Moustafa, A., Thomas, G., & Carmo, K. B. (2021). How should the neonatal retrieval team respond to the neonate referred with bilious vomiting? Journal of Paediatrics and Child Health, 58(5), 774-781.
https://doi.org/10.1111/jpc.15829
16. Mohinuddin, S., Sakhuja, P., Bermundo, B., Ratnavel, N., Kempley, S., Ward, H. C., & Sinha, A. (2014). Outcomes of full-term infants with bilious vomiting: Observational study of a retrieved cohort. Archives of Disease in Childhood, 100(1), 14-17.
https://doi.org/10.1136/archdischild-2013-305724
17. Godbole, P., & Stringer, M. D. (2002). Bilious vomiting in the newborn: How often is it pathologic? Journal of Pediatric Surgery, 37(6), 909-911.
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