Gastroenterology Book

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Vomiting Causes in Children

Aka: Vomiting Causes in Children
  1. See Also
    1. Vomiting in Children
    2. Triage of Children with Vomiting
    3. Vomiting Management in Children
    4. Pediatric Diarrhea
    5. Pediatric Dehydration
  2. Causes: Age related
    1. Newborn (age <1 month)
      1. Vomiting in a newborn is abnormal until serious causes are excluded
      2. Gastrointestinal obstruction (abdominal distention, Unconsolable Infant, poor feeding)
        1. Intestinal Malrotation
      3. Infection or Sepsis (fever, listless)
        1. Urinary Tract Infection
        2. Meningitis
        3. Bacteremia
      4. Ill appearing without infection
        1. Inborn Errors of Metabolism
        2. Necrotizing Enterocolitis (Premature Infants)
      5. Other causes
        1. Spitting Up
    2. Infants (age 1 month to 1 year)
      1. Mechanical gastrointestinal obstruction
        1. Pyloric Stenosis
          1. Age 3-6 week old (nearly always by 3 months)
          2. Nonbilious Emesis within minutes of feeding
        2. Intussusception
          1. Age 3 months to 3 years
          2. Intractable Vomiting, lethargy and paroxysms of intermittent Abdominal Pain
      2. Infection
        1. Viral Gastroenteritis (diagnosis of exclusion, unless also with concurrent Diarrhea)
        2. Bacterial enteritis
        3. Acute Otitis Media
        4. Urinary Tract Infection
      3. Other serious causes
        1. Nonaccidental Trauma with abusive Head Injury
    3. Children (age >1 year)
      1. Infection
        1. Viral Gastroenteritis (see comments above)
        2. Appendicitis (guarding, Rebound Tenderness, Rosving Sign, Psoas Sign)
        3. Urinary Tract Infection
      2. Other serious causes
        1. Diabetic Ketoacidosis
        2. Testicular Torsion
        3. Intussusception
  3. Causes: Common
    1. Gastroesophageal Reflux
    2. Infectious Gastroenteritis
    3. Urinary Tract Infection
    4. Foodborne Illness
  4. Causes: Increased Intracranial process
    1. Meningitis
    2. Intracranial tumor
    3. Pseudotumor Cerebri
  5. Causes: Metabolic
    1. Galactosemia
    2. High ammonia
    3. Congenital Adrenal Hyperplasia
    4. Phenylketonuria
    5. Organic acidemia
    6. Hypokalemia
    7. Hypermagnesemia
    8. Hypercalcemia
  6. Causes: Medications
    1. Aspirin
    2. Alcohol
    3. Erythromycin
    4. Theophylline
    5. Opiates
    6. Iron
    7. Furadantin
  7. Causes: Infectious
    1. Otitis Media
    2. Pneumonia
    3. Sepsis
    4. Pertussis
  8. Causes: Anatomic malformation
    1. Pyloric Stenosis
    2. Intussusception
    3. Malrotation
    4. Volvulus
    5. Inguinal Hernia
    6. Intestinal adhesions
    7. Gastric web
    8. Esophageal atresia
    9. Intestinal atresia
    10. Hirschsprung's Disease
    11. Annular Pancreas
    12. Imperforate anus
    13. Meconium ileus
    14. Small left colon
    15. Gastroschisis
    16. Omphalocele
    17. Prostaglandin-induced antral hypertrophy
  9. Causes: Miscellaneous
    1. Obstructive uropathy
    2. Vascular anomaly (Superior Mesenteric Artery Syndrome)
    3. Necrotizing Enterocolitis (NEC)
    4. Protein-sensitive enterocolitis
    5. Peptic Ulcer Disease (Gastric or Duodenal Ulcer)
    6. Gastritis
    7. Esophagitis
    8. Appendicitis
    9. Meckel's Diverticulum
    10. Pseudo-obstruction
    11. Increased Intracranial Pressure (e.g. Shaken Baby Syndrome)
  10. References
    1. (2017) Crit Dec Emerg Med 31(4): 19-25

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