What type of obstruction is more likely to result in bilious emesis and delayed diagnosis?

The situation where bilious emesis occurs is typically associated with an obstruction that is at or above the level of the duodenum, particularly because the bile, which gives vomit its characteristic greenish color, begins to enter the gastrointestinal tract at the duodenum.

When considering the types of obstructions, a lower obstruction refers to one situated in a more distal segment of the intestines, while a higher obstruction is located closer to the stomach. Notably, vague symptoms can result from a lower obstruction due to the presence of a compensatory bowel function that may allow for gradual adjustment. This can lead to delayed diagnosis as the symptoms may be less pronounced or atypical, allowing a healthcare provider to postpone further investigation.

In summary, a lower obstruction is more likely to go unnoticed initially, resulting in bilious vomiting as the condition progresses, since the obstruction does not allow bile to be cleared effectively. This delay in diagnosis highlights the importance of careful evaluation of emesis types and associated symptoms in neonates.