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Proximal intestinal obstruction results in early vomiting in the neonate. The site of the block is usually at the third part of the duodenum distal to the ampulla of Vater, when the vomit is bile-stained. A double bubble shadow may be seen on abdominal radiology.
In large bowel obstruction, the vomit may become faeculant if the obstruction is not recognised. Distended loops of bowel and fluid levels will be seen on a plain erect abdominal film.