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Title of Journal: Pediatr Surg Int

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Abbravation: Pediatric Surgery International

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Springer-Verlag

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DOI

10.1016/0300-9572(94)90224-0

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1437-9813

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Chronic bilious vomiting in children in developing

Authors: Anand Pandey V Kumar A N Gangopadhyay S P Sharma S C Gopal D K Gupta S C U Patne
Publish Date: 2009/11/13
Volume: 26, Issue: 2, Pages: 213-217
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Abstract

Bilious vomiting in conjunction with abdominal pain is considered to be a surgical problem unless proved otherwise In children besides tuberculosis TB we have found jejunal stricture JS due to nonspecific jejunoileitis NSJI to be an important cause of chronic high small bowel obstruction and bilious vomitingIn this retrospective study the records of all children with complaint of intermittent bilious vomiting and failure to thrive were evaluated Investigations included oral contrast study ultrasound abdomen chest Xray and Mantoux test Final confirmation was made at laparotomy Treatment included jejunojejunal resection and anastomosis Histopathology of the specimen was done to look for caseation granuloma formation and other detailsOut of total 100 patients with the complaint of bilious vomiting 25 were having JS Radiologic confirmation was possible in 19 76 patients of JS No patient had evidence of TB as per our protocol Histopathology revealed nonspecific ischemic changes in all specimensJejunal stricture due to NSJI is a common entity in our setup leading to bilious vomiting Contrast study can provide high index of suspicion in most of the patients The diagnosis must be confirmed after proper histopathological examination The results of the surgery are excellent

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