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• W4381144688 abstract "<h3>Objectives</h3> Bilious vomiting in newborn infants can be a presenting feature of underlying serious surgical conditions warranting an urgent transfer to surgical centres.¹ There is a concern that too many infants are transferred to surgical centres, thereby burdening transfer, radiological and surgical services within neonatal networks. There is little agreement about the colour of the vomitus containing bile.² We aim to evaluate the outcomes of a recent cohort of transfers by a regional neonatal transfer service and assess the correlation with the colour of the vomitus. <h3>Methods</h3> We conducted a prospective evaluation of term infants (>37 weeks) referred as bilious vomiting between April 2021 to March 2022. Assessment of the colour of the vomitus/aspirate was undertaken using a standardised colour chart (figure 1). The colour of the vomitus was recorded by the referral unit staff and the transfer team staff independently. Follow-up data were obtained following the transfers from transfer records and Badgernet data. <h3>Results</h3> 142 babies were transferred, and outcome data were available on 136 infants. Demographics, clinical, and radiological findings and outcomes are shown in table 1. Ten infants had abnormal antenatal scans, with confirmed GI abnormalities in three. 133 underwent an upper GI contrast study. 11 upper GI contrast studies (8%) were abnormal and underwent laparotomy. The findings were: volvulus/malrotation (n=8), gut atresia (n=2), and 1 baby had dilated loops at laparotomy. Referral unit staff scored the colour of the vomitus/aspirate in 75% of infants, and the transfer team scored the vomitus/aspirate in 63.2% of infants. The colour data was divided into four quadrants: right upper – D1 to F3, right lower – D4 to F6, left upper – A1 to C3 and left lower – A4 to C6 and correlated with the outcomes as shown in figure 1. Of those with a positive contrast study, 78% had an aspirate which scored on the right side of the Bilibear chart (dark green) however those with a normal contrast study scored equally between the 2 sides of the chart (47% left, 53% right). <h3>Conclusion</h3> There is a reduction in babies presenting with bilious vomiting who have a surgical pathology, as compared to our previous cohort.¹ There is no significant association between the colour of the vomitus and surgical pathology. Gold standard advice should stand that all babies with bilious vomiting must undergo an upper GI contrast study to confirm or exclude any surgical pathology. <h3>References</h3> Mohinuddin S, Sakhuja P, Bermundo B, <i>et al</i>. Outcomes of full-term infants with bilious vomiting: observational study of a retrieved cohort. <i>Archives of Disease in Childhood</i> 2015 Jan;<b>100</b>(1):14–7 Walker GM, <i>et al</i>. Colour of bile vomiting in intestinal obstruction in the newborn: questionnaire study. <i>BMJ</i> 2006; BMJ.38859.614352.55v1" @default.
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• W4381144688 date "2023-06-19" @default.
• W4381144688 modified "2023-09-25" @default.
• W4381144688 title "908 Can the colour of vomitus predict the outcomes of infants transferred with bilious vomiting?" @default.
• W4381144688 doi "https://doi.org/10.1136/archdischild-2023-rcpch.270" @default.
• W4381144688 hasPublicationYear "2023" @default.
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