Bilious vomiting in a neonate should be equated to malrotation with midgut volvulus until proven otherwise. This is a surgical emergency requiring upper gastrointestinal series to rule out malrotation/small bowel obstruction and transfer to a tertiary care facility with availability of pediatric surgeons.

Bilious vomiting in a neonate should be equated to malrotation with midgut volvulus until proven otherwise. This is a surgical emergency requiring upper gastrointestinal series to rule out malrotation/small bowel obstruction and transfer to a tertiary care facility with availability of pediatric surgeons.