Bilious Vomiting Etiological Factors and Outcomes in Neonates of a Tertiary Care Hospital of Khyber Pukhtunkhwa, Peshawar; A Cross-sectional Study

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.