BILOUS VOMITING IN A 2WK OLD CHILD----

probable diagnosis will be---
1)malrotation of gut
2)duodenal atresia
3)pyloric stenosis
4)hirschprung's disease

friends,PlZ somebody throw some light in this Q-----perhaps it remained unnoticed!!!

gud qn this..a thinker..hirschprung ds & hps r obviously out. both duodenal atresia & malrotation can present with similr picture with vomiting, bilious or otherwise depending on site of obstruction..i wud say malrotation as the answr here as duodenl atresia tends to present early in the neonatal period..

i have searched a lot about this question.
all the std books including Sabiston give duodenal atresia and malrotation as differentials of neonatal bilious vomiting..

- as was already pointed out, duodenal atresia presents mostly in the first week of life
malrotation presents 60% times before 1 month of age. 20% cases are seen after 25yrs of age.

-according to international journal of pediatrics (www.springerlink.com)- if a neonate presents with bilious vomiting, first MALROTATION has to be ruled out.

thus, the answer seems to be MALROTATION OF GUT..
LETS PRAY SUCH CONFUSING QUESTIONS ARE NOT ASKED IN ALL INDIA.!