Review Note
Last Update: 06/09/2024 07:26 PM
Current Deck: SLS Cards::10. Pediatric growth and nutrition
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Commit #107610
What is the DDx for an 8 week old with acute vomiting?
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Commit #107610
Structural
- GERD (common in infants due to immature LES; recurrent non-bilious vomiting, irritability, feeding difficulties, poor weight gain)
- Pyloric stenosis (most common 3-6 weeks but up to 12; projectile and non-bilious vomiting, palpable olive-shaped mass in abdo, visible peristalsis, dehydration and electrolyte imbalances
- Intestinal obstruction
- Intussusception (most common 3-12 mo; intermittent abdo pain, jelly-like/ currant stool, vomiting bilious or non)
- Hirschprungs (usually newborn; bilious vomiting, abdo distension, failure to pass mec in first 48 hrs)
- Malrotation with midgut volvulus (anywhere from newborn - 5 yo; bilious vomiting, abdo distension, lethargy)
- Viral gastroenteritis (e.g. rotavisus, norovirus)
- Bacterial gastroenteritis (e.g. E. coli, Salmonella spp)
- Parasitic gastroenteritis (e.g. Giardia spp)
- UTI (females and uncircumsized males; vomiting, fever, irritability)
- Sepsis (fever, lethargy, poor feeding, vomiting)
- Inborn errors of metabolism (usually first few week; vomiting, poor feeding, lethargy, FTT)
Allergic
- Food protein-induced enterocolitis syndrome (FPIES; typically cows milk or soy; vomiting, diarrhea, dehydration after feeding)
Other
- Intracranial pathology (vomiting, altered mental status)
- Hydrocephalus
- Increased ICP
- Congenital heart disease (poor feeding, vomiting, cyanosis, FTT)
- Overfeeding or improper feeding techniques
- Ingested toxins or medications