What is the recommended treatment for a 1-month-old boy presenting with bilious vomit and a swollen abdomen indicative of a possible bowel obstruction?

In the case of a 1-month-old boy presenting with bilious vomiting and a swollen abdomen, indicating a possible bowel obstruction, the appropriate treatment involves surgical intervention. The most common cause of such obstruction in infants is conditions like intussusception or malrotation with volvulus.

Open surgical repair is critical in these scenarios, as it allows for direct visualization and correction of the underlying problem, such as untwisting the bowel or resecting any necrotic segments. This type of intervention is particularly suitable for cases where the obstructive process might lead to ischemia or perforation of the bowel, conditions that are surgical emergencies.

In contrast, other options such as a barium enema may be beneficial for diagnostic purposes but are not curative for acute obstructions and may even worsen the situation in cases of perforation. Duodenoduodenostomy is typically indicated for specific types of congenital duodenal obstruction, and pyloromyotomy is another surgical procedure but is specifically aimed at hypertrophic pyloric stenosis, which presents differently than what is described here.

Thus, the choice of open surgical repair is the most appropriate and effective course of action for this infant's acute presentation.