In the assessment of an infant with tachypnea, which sign is most indicative of a gastrointestinal obstruction?

In the assessment of an infant with tachypnea, bilious emesis is highly indicative of a potential gastrointestinal obstruction. Bilious emesis refers to the vomiting of bile, which is a digestive fluid produced by the liver. The presence of bile in the vomit signals that the obstruction is located distal to the ampulla of Vater, meaning that the normal pathway for bile drainage is blocked, leading to the regurgitation of bile into the stomach and subsequently being vomited.

When an obstruction occurs in the gastrointestinal tract, especially at certain levels, it can prevent the normal progression of intestinal contents. This can cause bile to back up, resulting in vomiting that has a greenish color, characteristic of bile. Therefore, bilious emesis is a clear red flag in assessing possible gastrointestinal issues and warrants immediate investigation.

While projectile vomiting, decreased bowel sounds, and weight loss may be concerning signs in a broader context of gastrointestinal or systemic issues, they do not specifically indicate a gastrointestinal obstruction as clearly as bilious emesis does. Projectile vomiting can occur in various conditions but is not exclusively linked to obstruction. Decreased bowel sounds may be observed, especially if there is significant ileus or obstruction, but it does not specifically indicate the presence of bile. Weight loss