Vomiting Causes in Children

Aka: Vomiting Causes in Children

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II. 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

III. Causes: Common

  1. Gastroesophageal Reflux
  2. Infectious Gastroenteritis
  3. Urinary Tract Infection
  4. Foodborne Illness

IV. Causes: Increased Intracranial process

  1. Meningitis
  2. Intracranial tumor
  3. Pseudotumor Cerebri

V. Causes: Metabolic

  1. Galactosemia
  2. High ammonia
  3. Congenital Adrenal Hyperplasia
  4. Phenylketonuria
  5. Organic acidemia
  6. Hypokalemia
  7. Hypermagnesemia
  8. Hypercalcemia

VI. Causes: Medications

  1. Aspirin
  2. Alcohol
  3. Erythromycin
  4. Theophylline
  5. Opiates
  6. Iron
  7. Furadantin

VII. Causes: Infectious

  1. Otitis Media
  2. Pneumonia
  3. Sepsis
  4. Pertussis

VIII. 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

IX. 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)

X. References

  1. (2017) Crit Dec Emerg Med 31(4): 19-25

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