Vomiting is the main symptom of gastrointestinal abnormalities and one of the most common clinical symptoms in pediatric internal and external medicine clinics. Due to the imperfect development of the nervous system of infants and young children, they are not cooperative in physical examination and are unable to communicate verbally, so they often visit the clinic with vomiting and crying. In general, most of the vomiting containing bile is surgical disease; while fecal-like vomiting can basically be concluded to be surgical disease. And bile-free vomiting can be a medical disease or a surgical disease, so it is bile-free vomiting that is not easy to identify between internal and surgical. In terms of surgery, the diseases that cause bileless vomiting are mostly upper gastrointestinal tract malformations, such as: esophageal atresia, gastroesophageal reflux, diaphragmatic hernia, gastric torsion, esophageal hiatal hernia, pyloric stenosis, etc. The above diseases are mostly without abdominal signs such as abdominal distension, abdominal pain, etc., and even abdominal radiographs have no obvious abnormalities, so they are easily confused with internal diseases, and the diagnosis can be confirmed only by medical history and gastrointestinal imaging. This will improve the diagnosis rate and reduce the misdiagnosis rate. According to the nature, color and degree of vomiting vomit on the preliminary judgment of surgical disease: 1, no bile vomit: vomit for white stomach contents, such as vomiting is not violent, mostly seen in functional vomiting, gastroesophageal reflux, gastric torsion, esophageal hiatus hernia, etc.. If the vomiting is violent, jet-like, mostly pyloric obstruction (such as congenital hypertrophic pyloric stenosis). 2, bilious vomiting: vomit is yellow-green liquid, not thick, often distal duodenal jugular obstruction, such as poor intestinal rotation, duodenal stenosis, cricothyroid pancreas, superior mesenteric artery compression syndrome, jejunal stenosis at the beginning. 3, fecal-like vomiting: vomit is brownish yellow and thick with foul odor, which mostly indicates lower intestinal obstruction, intestinal atresia, congenital megacolon, etc. 4, bloody vomiting: vomit with blood is mostly caused by bleeding ulcers in the proximal esophagus, stomach or duodenum mucosa of the flexural ligament. If vomiting blood and abdominal pain, abdominal distension, abdominal muscle tension, should think of intestinal torsion necrosis, strangulated intestinal obstruction may.