A case of bilious vomiting in a 9-month-old male is reported. The diff
erential diagnosis of infantile bilious vomiting is reviewed, and appr
opriate diagnostic studies are discussed. The child was found to have
intussusception. The common manifestation of this pediatric surgical e
mergency may vary considerably from classic descriptions. Bilious emes
is in infants must be considered a surgical emergency until proven oth
erwise; intussusception may manifest as bilious vomiting only.