Abstract: | Bilious (dark green) vomiting in the newborn is a surgical emergency as the underlying diagnosis may be volvulus of the entire midgut secondary to malrotation. This diagnosis is time-critical because if untreated, volvulus will lead to midgut necrosis resulting in short gut syndrome or death. While a range of other diagnoses are possible, transfer to a paediatric surgical centre should be undertaken promptly so that malrotation volvulus can be excluded or treated. This review focuses on the causes, investigation, and management of proximal bowel obstruction in the neonate that present primarily with bilious vomiting. |