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Bilious Emesis in the Pediatric Emergency Department: Etiology and Outcome

Mount Sinai School of Medicine, Mount Sinai University Medical Center, New York

Shireen M. Atabaki, MD, MPH

Christina M.S. Johns, MD

James M. Chamberlain, MD

Stephen J. Teach, MD, MPH

George Washington University School of Medicine and Health Sciences, Children's National Medical Center, Washington, DC

The objective of this study was to describe the emergency department (ED) diagnoses in an unselected pediatric population with bilious emesis. In a multicenter, prospective, observational case series, a convenience sample of patients less than 21 years old with yellow or green emesis were assembled. Clinical review of each case was performed 2 weeks or longer after ED disposition. Two hundred twenty-seven patients with 230 ED encounters were enrolled. Of the 189 encounters (82.2%) with follow-up, 20 had surgical disease (10.6%; 95% C.I. 6.6%, 15.9%). There was no significant association between the color of the emesis and surgical disease (OR=2.3; 95% CI, 0.68, 8.6).

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