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PEDIATRICS VOMITING

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Approach

  1. consider: infection, inflammation, mechanical obstruction, motility disorders, others (e.g. eating disorder)
  2. Non GI causes: CNS, UTI, systemic infections, others
Assessment 

History
  1. age of onset, duration, severity
  2. quality: bilious, bloody, regurgitation
  3. associated symptoms e.g. fever, abdominal pain
  4. effect on growth and development, concurrent disease 

physical exam: assess hydration




lab investigation
  1. bloody emesis: investigate for causes of upper GI bleed
  2. bilious emesis: rule out obstruction (upper GI series, U/S)
  3. regurgitation: evaluate for reflux (barium swallow with fluoroscopy, 24 hour esophageal pH probe)

useful tests (based on history and physical exam)
  1. CBC, lytes, BUN, Cr, ESR
  2. urine, blood, stool C&S
  3. amylase, lipase
  4. arterial blood gases
  5. abdominal x-ray, ultrasound, contrast radiology
  6. endoscopy

management
  1. treat the underlying cause
  2. rehydration
PEDIATRICS VOMITING PEDIATRICS VOMITING Reviewed by Radiology Madeeasy on December 29, 2010 Rating: 5
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