II. Causes: Age related
- Newborn (age <1 month)
- Vomiting in a newborn is abnormal until serious causes are excluded
- Gastrointestinal obstruction (Abdominal Distention, Unconsolable Infant, poor feeding)
- Infection or Sepsis (fever, listless)
- Urinary Tract Infection
- Meningitis
- Bacteremia
- Ill appearing without infection
- Other causes
- Infants (age 1 month to 1 year)
- Mechanical gastrointestinal obstruction
- Pyloric Stenosis
- Age 3-6 week old (nearly always by 3 months)
- Nonbilious Emesis within minutes of feeding
- Intussusception
- Age 3 months to 3 years
- Intractable Vomiting, lethargy and paroxysms of intermittent Abdominal Pain
- Pyloric Stenosis
- Infection
- Viral Gastroenteritis (diagnosis of exclusion, unless also with concurrent Diarrhea)
- Bacterial enteritis
- Acute Otitis Media
- Urinary Tract Infection
- Other serious causes
- Nonaccidental Trauma with abusive Head Injury
- Mechanical gastrointestinal obstruction
- Children (age >1 year)
- Infection
- Viral Gastroenteritis (see comments above)
- Appendicitis (guarding, Rebound Tenderness, Rosving Sign, Psoas Sign)
- Urinary Tract Infection
- Other serious causes
- Infection
III. Causes: Common
IV. Causes: Increased Intracranial process
- Meningitis
- Intracranial tumor
- Pseudotumor Cerebri
V. Causes: Metabolic
- Galactosemia
- High ammonia
- Congenital Adrenal Hyperplasia
- Phenylketonuria
- Organic acidemia
- Hypokalemia
- Hypermagnesemia
- Hypercalcemia
VI. Causes: Medications
VII. Causes: Infectious
VIII. Causes: Anatomic malformation
- Pyloric Stenosis
- Intussusception
- Malrotation
- Volvulus
- Inguinal Hernia
- Intestinal adhesions
- Gastric web
- Esophageal atresia
- Intestinal atresia
- Hirschsprung's Disease
- Annular Pancreas
- Imperforate anus
- Meconium ileus
- Small left colon
- Gastroschisis
- Omphalocele
- Prostaglandin-induced antral hypertrophy
IX. Causes: Miscellaneous
- Obstructive uropathy
- Vascular anomaly (Superior Mesenteric Artery Syndrome)
- Necrotizing Enterocolitis (NEC)
- Protein-sensitive enterocolitis
- Peptic Ulcer Disease (Gastric or Duodenal Ulcer)
- Gastritis
- Esophagitis
- Appendicitis
- Meckel's Diverticulum
- Pseudo-obstruction
- Increased Intracranial Pressure (e.g. Shaken Baby Syndrome)
X. References
- (2017) Crit Dec Emerg Med 31(4): 19-25