PEDIATRIC VOMITING

Pediatric Vomiting Vomiting Evaluate for Surgical/Acute Abdomen Bilious emesis (green emesis) Red Flags* Bilious (Surgical/Acute Abdomen) Malrotation / Volvulus Intussusception Obstruction (e.g., Intestinal atresia) Non-Bilious Acute Gastrointestinal Disease Appendicitis / Obstruction (e.g., Pyloric stenosis, Intestinal atresia) Intussusception Gastroenteritis Gastroparesis / Ileus Hepatitis Pancreatitis Cholecystitis Other Systemic Disease Infection (e.g., Meningitis, Encephalitis, Sepsis, UTI, Pneumonia) CNS disease (e.g., Head injury / Concussion, ↑ ICP*, Brain tumor, Abusive head trauma, Migraine) Metabolic disease* (e.g., DKA, Diabetes mellitus) Chronic Evaluate for Red Flags: Bloody emesis Morning emesis Weight loss / Failure to thrive Systemic symptoms (fever, unwell, etc.) Red Flags Present Gastrointestinal Disease Inflammatory bowel disease (e.g., Crohn’s Disease) Peptic ulcer Other Systemic Disease CNS disease (↑ ICP*, Brain tumor) Renal disease* (e.g., renal failure) Endocrine illness* (Diabetes mellitus, Addison’s disease, Thyroid disease) Metabolic disease* No Red Flags Gastrointestinal Disease GERD Cyclic vomiting syndrome Other Systemic Disease CNS disease (e.g., Head injury / Concussion, Migraine) Hypersensitivity* (e.g., Asthma) Middle ear disease* (e.g., Otitis media) Drugs / Tox