ABDOMINAL, GASTROINTESTINAL, AND GENITOURINARY EMERGENCIES Goals of Treatment Patient with gastrointestinal emergencies may have massive fluid requirements because of third spacing Hypoglycemia and shock are common Abdominal distention can interfere with ventilation Delays in definitive surgical intervention are associated with worse outcome Therefore, the goals of emergency care are to aggressively fluid resuscitate, to provide adequate glucose, and to decompress the abdomen with nasogastric drainage Some patients will require intubation Urgent consultation with a pediatric surgeon and radiologist will aid in definitive diagnosis and surgical treatment KEY POINTS Bilious emesis in a newborn is a surgical emergency and presumed malrotation until proven otherwise Decompression of obstructed bowel with a nasogastric tube will reduce hydrostatic pressure and lower the risk of ischemia of the gut RELATED CHAPTERS Signs and Symptoms Crying: Chapter 20 Medical, Surgical, and Trauma Emergencies Endocrine Emergencies: Chapter 89 Gastrointestinal Emergencies: Chapter 91 Malrotation and Volvulus CLINICAL PEARLS AND PITFALLS