Vomiting in children: Difference between revisions

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==Overview==
==Overview==
Vomiting in children is common and can range from [[benign]] condition to life-threatening condition. Most cases of vomiting are [[gastrointestinal]] in origin, most commonly [[gastroesophageal reflux disease]] and [[gastroenteritis]].
Vomiting in children is common and can range from a [[benign]] condition to a life-threatening condition. Most cases of vomiting are [[gastrointestinal]] in origin, most commonly [[gastroesophageal reflux disease]] and [[gastroenteritis]].
Vomiting, also known as [[emesis]], is the oral expulsion of [[gastrointestinal]] content from the mouth due to the [[gut]] and [[thoracoabdominal]] wall muscles' contraction. At the same time, [[nausea]] refers to the need to vomit. [[Retching]] is used to describe the muscular event of vomiting with the expulsion of [[vomitus]].
Vomiting, also known as [[emesis]], is the oral expulsion of [[gastrointestinal]] content from the mouth due to the [[gut]] and thoracoabdominal wall muscles' contraction. At the same time, [[nausea]] refers to the need to vomit. [[Retching]] is used to describe the muscular event of vomiting with the expulsion of [[vomitus]].


==Historical Perspective==
==Historical Perspective==


There is limited information about the historical perspective of vomiting in children
There is limited information about the historical perspective of vomiting in children.


==Classification==
==Classification==
Vomiting in children may be classified according to the content of vomitus into :
Vomiting in children may be classified according to the content of vomitus, motion, and duration into:


*Bloody and non-bloody
*Bloody and non-bloody
*[[Bilious]] and non-bilious
*[[Bilious]] and non-bilious
*Projectile and non-projectile. <ref>https://www.mayoclinic.org/symptoms/vomiting-blood/basics/causes/sym-20050732</ref><ref name="AndradeMarin2020">{{cite journal|last1=Andrade|first1=Gabriela Bonente Herculano de|last2=Marin|first2=Barbara Said|last3=Medeiros|first3=Daniela Nasu Monteiro|last4=Yamanari|first4=Mauricio Gustavo Ieiri|last5=Troster|first5=Eduardo Juan|title=Vomiting in newborns as a result of a duodenal membrane: two case reports|journal=Einstein (São Paulo)|volume=18|year=2020|issn=1679-4508|doi=10.31744/einstein_journal/2020RC4641}}</ref><ref name="pmidhttps://doi.org/10.1542/pir.19-10-33">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=https://doi.org/10.1542/pir.19-10-33 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref>
*Projectile and non-projectile
*[[Acute]] and [[chronic]] <ref name="AndradeMarin2020">{{cite journal|last1=Andrade|first1=Gabriela Bonente Herculano de|last2=Marin|first2=Barbara Said|last3=Medeiros|first3=Daniela Nasu Monteiro|last4=Yamanari|first4=Mauricio Gustavo Ieiri|last5=Troster|first5=Eduardo Juan|title=Vomiting in newborns as a result of a duodenal membrane: two case reports|journal=Einstein (São Paulo)|volume=18|year=2020|issn=1679-4508|doi=10.31744/einstein_journal/2020RC4641}}</ref><ref name="pmid30567916">{{cite journal| author=Galea R, Said E| title=Infantile Hypertrophic Pyloric Stenosis: An Epidemiological Review. | journal=Neonatal Netw | year= 2018 | volume= 37 | issue= 4 | pages= 197-204 | pmid=30567916 | doi=10.1891/0730-0832.37.4.197 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30567916  }} </ref><ref name="pmid27401959">{{cite journal| author=Tomasik E, Ziółkowska E, Kołodziej M, Szajewska H| title=Systematic review with meta-analysis: ondansetron for vomiting in children with acute gastroenteritis. | journal=Aliment Pharmacol Ther | year= 2016 | volume= 44 | issue= 5 | pages= 438-46 | pmid=27401959 | doi=10.1111/apt.13728 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27401959 }} </ref>


==Pathophysiology==
==Pathophysiology==


*The vomiting center is found in the [[medulla]] oblongata's reticular formation with [[muscarinic]] type receptor, which activates the vomiting center. The Signals then out to the abdominal muscle via the [[efferent pathway]] with the [[trigeminal]] (CN V), [[facial]](CN VII), [[glossopharyngeal]] (CN IX), [[vagus]](CN X), and [[hypoglossal]] (CN XII) to the [[upper GI tract]], within [[vagal]] and [[sympathetic nerves]] to the lower tract, and within [[spinal nerves]] to the diaphragm and abdominal muscles. This vomiting center can also be triggered by the [[chemoreceptor trigger zone]] (CTRZ), which contains Dopamine 2 receptor, the CRTZ located outside the [[blood-brain barrier]].<ref name="pmidhttps://doi.org/10.1542/pir.19-10-33">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=https://doi.org/10.1542/pir.19-10-33 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10  }} </ref><ref name="pmid21174569">{{cite journal| author=Becker DE| title=Nausea, vomiting, and hiccups: a review of mechanisms and treatment. | journal=Anesth Prog | year= 2010 | volume= 57 | issue= 4 | pages= 150-6; quiz 157 | pmid=21174569 | doi=10.2344/0003-3006-57.4.150 | pmc=3006663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21174569  }} </ref>
 
*The vomiting center can be triggered by the [[gastrointestinal]] (GI) tract, the [[vestibular system]], the [[chemoreceptor trigger zone]], and higher centers in the [[cortex]] and [[thalamus]].
*The vomiting center is found in the [[medulla oblongata]]'s reticular formation with [[muscarinic]] type receptor, which activates the vomiting center. Signals are then sent out to the abdominal muscle via the efferent pathway with the [[trigeminal]] (CN V), [[facial]] (CN VII), [[glossopharyngeal]] (CN IX), [[vagus]] (CN X), and [[hypoglossal]] (CN XII) to the upper [[gastrointestinal tract]], within [[vagal]] and [[sympathetic]] nerves to the lower tract, and within [[spinal]] nerves to the [[diaphragm]] and abdominal muscles causing vomiting.
*The [[chemoreceptor trigger zone]] (CTRZ), which contains the Dopamine 2 receptor, is located outside the [[blood-brain barrier]] and can be activated directly by an irritant.<ref name="pmid21174569">{{cite journal| author=Becker DE| title=Nausea, vomiting, and hiccups: a review of mechanisms and treatment. | journal=Anesth Prog | year= 2010 | volume= 57 | issue= 4 | pages= 150-6; quiz 157 | pmid=21174569 | doi=10.2344/0003-3006-57.4.150 | pmc=3006663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21174569  }} </ref>


==Causes==
==Causes==


Common causes of Vomiting in children include  
Common causes of vomiting in children include:


*[[Acute gastroenteritis]]
*[[Acute gastroenteritis]]
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*[[Appendicitis]]
*[[Appendicitis]]
*[[Volvulus]]
*[[Volvulus]]
*[[Inflammation]] of the  GI tract including esophagitis, gastroenteritis, peptic ulcer disease, hepatitis, pancreatitis, cholecystitis or appendicitis, may cause vomiting
*[[Inflammation]] of the  GI tract including [[esophagitis]], [[gastroenteritis]], [[peptic ulcer disease]], [[hepatitis]], [[pancreatitis]], [[cholecystitis]] or [[appendicitis]] may cause vomiting
*[[Hepatitis]]
*[[Hepatitis]]
*[[Gallbladder]] disease
*[[Gallbladder]] disease
*[[Pancreatitis]]
*[[Pancreatitis]]
*CNS injury [[concussion]]/[[postconcussion syndrome]], [[increased intracranial pressure]] (ICP), [[migraine headache]] and [[viral meningitis]].
*CNS injury [[concussion]]/[[post-concussion syndrome]], [[increased intracranial pressure]] (ICP), [[migraine headache]] and [[viral meningitis]].
*[[Renal]] dx
*[[Renal]] disease
*Drugs
*Drugs <ref name="pmid33263676">{{cite journal| author=Andrade GBH, Marin BS, Medeiros DNM, Yamanari MGI, Troster EJ| title=Vomiting in newborns as a result of a duodenal membrane: two case reports. | journal=Einstein (Sao Paulo) | year= 2020 | volume= 18 | issue=  | pages= eRC4641 | pmid=33263676 | doi=10.31744/einstein_journal/2020RC4641 | pmc=7687917 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33263676  }} </ref><ref>https://www.merckmanuals.com/professional/pediatrics/symptoms-in-infants-and-children/nausea-and-vomiting-in-infants-and-children</ref>


==Differentiating [disease name] from other Diseases==
==Differentiating [disease name] from other Diseases==


Vomiting in children must be differentiated from other diseases that cause vomiting in children such as [[Cyclic vomiting syndrome]] (CVS)<ref name="pmid33224097">{{cite journal| author=Raucci U, Borrelli O, Di Nardo G, Tambucci R, Pavone P, Salvatore S | display-authors=etal| title=Cyclic Vomiting Syndrome in Children. | journal=Front Neurol | year= 2020 | volume= 11 | issue=  | pages= 583425 | pmid=33224097 | doi=10.3389/fneur.2020.583425 | pmc=7667239 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33224097  }} </ref> [[Gastrointestinal]] disease (obstructive and inflammatory)<ref name="pmid18646021">{{cite journal| author=Sullivan PB| title=Gastrointestinal disorders in children with neurodevelopmental disabilities. | journal=Dev Disabil Res Rev | year= 2008 | volume= 14 | issue= 2 | pages= 128-36 | pmid=18646021 | doi=10.1002/ddrr.18 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18646021  }} </ref>, [[Central Nervous System]] (CNS) disease, [[pulmonary]] disease, [[renal]] disease, [[endocrine]]/[[metabolic]] disorders, drugs (either as side effects or in [[Overdose]]), or [[psychiatric]] disorders.<ref> https://www.medscape.com/viewarticle/711641_3</ref>
Vomiting in children must be differentiated from other diseases that cause vomiting in children such as [[cyclic vomiting syndrome]] (CVS) <ref name="pmid33224097">{{cite journal| author=Raucci U, Borrelli O, Di Nardo G, Tambucci R, Pavone P, Salvatore S | display-authors=etal| title=Cyclic Vomiting Syndrome in Children. | journal=Front Neurol | year= 2020 | volume= 11 | issue=  | pages= 583425 | pmid=33224097 | doi=10.3389/fneur.2020.583425 | pmc=7667239 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33224097  }} </ref>, [[gastrointestinal]] disease (obstructive and inflammatory) <ref name="pmid18646021">{{cite journal| author=Sullivan PB| title=Gastrointestinal disorders in children with neurodevelopmental disabilities. | journal=Dev Disabil Res Rev | year= 2008 | volume= 14 | issue= 2 | pages= 128-36 | pmid=18646021 | doi=10.1002/ddrr.18 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18646021  }} </ref>, [[central nervous system]] (CNS) disease, [[pulmonary]] disease, [[renal]] disease, [[endocrine]]/[[metabolic]] disorders, drugs (either as side effects or in [[Overdose]]), or [[psychiatric]] disorders.


==Epidemiology and Demographics==
==Epidemiology and Demographics==


Vomiting in children is very and there is no racial, gender, age, or race predilection to vomiting in children.
Vomiting in children is very common and there are no racial, gender, age, or race predispstions to vomiting in children.


==Risk Factors==
==Risk Factors==
 
There are no established risk factors for vomiting in children.
There are no established risk factors for Vomiting in childdren.
 
==Natural History, Complications and Prognosis==
==Natural History, Complications and Prognosis==


*The majority of children with vomiting is mostly due to [[gastroenteritis]]. [[Gastroenteritis]] ranges from asymptomatic to [[dehydration]] to death, it usually starts with mild [[fever]] and vomiting, followed by 1-4 days of non-bloody, watery [[diarrhea]].<ref name="AndradeMarin2020">{{cite journal|last1=Andrade|first1=Gabriela Bonente Herculano de|last2=Marin|first2=Barbara Said|last3=Medeiros|first3=Daniela Nasu Monteiro|last4=Yamanari|first4=Mauricio Gustavo Ieiri|last5=Troster|first5=Eduardo Juan|title=Vomiting in newborns as a result of a duodenal membrane: two case reports|journal=Einstein (São Paulo)|volume=18|year=2020|issn=1679-4508|doi=10.31744/einstein_journal/2020RC4641}}</ref>
*The majority of children with vomiting is mostly due to [[gastroenteritis]]. [[Gastroenteritis]] ranges from asymptomatic to [[dehydration]] to death, and usually starts with mild [[fever]] and vomiting, followed by 1-4 days of non-bloody, watery [[diarrhea]].<ref name="AndradeMarin2020">{{cite journal|last1=Andrade|first1=Gabriela Bonente Herculano de|last2=Marin|first2=Barbara Said|last3=Medeiros|first3=Daniela Nasu Monteiro|last4=Yamanari|first4=Mauricio Gustavo Ieiri|last5=Troster|first5=Eduardo Juan|title=Vomiting in newborns as a result of a duodenal membrane: two case reports|journal=Einstein (São Paulo)|volume=18|year=2020|issn=1679-4508|doi=10.31744/einstein_journal/2020RC4641}}</ref>
 
*Common complications of vomiting in children is [[dehydration]].
*Common complications of complication of vomiting in children is [[dehydration]].
*Prognosis ranges from excellent to poor depending on the etiology of the vomiting (include [[gastroenteritis]] to [[meningitis]] respectively)
*Prognosis ranges from excellent to poor depending on the etiology of the vomiting (include [[gastroenteritis]] to [[meningitis]] respectively)


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===Diagnostic Criteria===
===Diagnostic Criteria===


*The diagnosis of Vomiting in children is made with both medical history and physical examination.
*The diagnosis of vomiting in children is made with both medical history and physical examination.


===Symptoms===
===Symptoms===


*Vomiting in children include the following:
*Symptoms of vomiting in children include the following:


:*[[Diarrhea]]
:*[[Fever]]
:*[[Fever]]
:*[[Lightheadedness]]
:*[[Lightheadedness]]
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:*[[Fainting]]
:*[[Fainting]]
:*[[Confusion]]
:*[[Confusion]]
:*Excessive [[sleepiness]]
:*Excessive [[sleepiness]] <ref name="pmid27175718">{{cite journal| author=Reust CE, Williams A| title=Acute Abdominal Pain in Children. | journal=Am Fam Physician | year= 2016 | volume= 93 | issue= 10 | pages= 830-6 | pmid=27175718 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27175718  }} </ref>


===Physical Examination===
===Physical Examination===


*Physical examination may be remarkable for:
*Physical examination may be remarkable for signs of [[dehydration]]:


:*[[Dry skin]]
:*[[Dry skin]]
:*[[Cracked lips]]
:*Cracked lips
:*Dark-[[Color]] [[urine]]
:*Dark-[[Color]] [[urine]]
:*[[Dizziness]]
:*[[Dizziness]]
:*[[Fatigue]]
:*[[Fatigue]]
:*[[Sweating]]
:*[[Sweating]]
:*Frequent urination. <ref> https://www.medscape.com/viewarticle/711641_1
:*Frequent urination. <ref name="pmid25870468">{{cite journal| author=Hoxha T, Xhelili L, Azemi M, Avdiu M, Ismaili-Jaha V, Efendija-Beqa U | display-authors=etal| title=Performance of clinical signs in the diagnosis of dehydration in children with acute gastroenteritis. | journal=Med Arch | year= 2015 | volume= 69 | issue= 1 | pages= 10-2 | pmid=25870468 | doi=10.5455/medarh.2015.69.10-12 | pmc=4384849 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25870468  }} </ref>
</ref><ref> https://kidshealth.org/en/parents/vomit.html#:~:text=In%20most%20cases%2C%20though%2C%20vomiting,%2C%20belly%20pain%2C%20and%20diarrhea</ref>


===Laboratory Findings===
===Laboratory Findings===


*There are no specific laboratory findings associated with vomiting in children. However, blood and urine test is helpful in diagnosis to check for infection and kidney function.
*There are no specific laboratory findings associated with vomiting in children. However, blood and urine tests are helpful in diagnosis to check for [[infection]] and [[kidney function]].


===Electrocardiogram===
===Electrocardiogram===
There are no ECG findings associated with vomiting in children.
There are no [[ECG]] findings associated with vomiting in children.
 
===X-ray===
===X-ray===
There are no x-ray findings associated with vomiting in children.
There are no [[x-ray]] findings associated with vomiting in children.
 
===Echocardiography or Ultrasound===
===Echocardiography or Ultrasound===
There are no echocardiography/ultrasound findings associated with vomiting in children.
There are no [[echocardiography]]/[[ultrasound]] findings associated with vomiting in children.
 
===CT scan===
===CT scan===
There are no CT scan findings associated with vomiting in children.
There are no [[CT scan]] findings associated with vomiting in children.
 
===MRI===
===MRI===
There are no MRI findings associated with vomiting in children.
There are no [[MRI]] findings associated with vomiting in children.
 
===Other Imaging Findings===
===Other Imaging Findings===
There are no other imaging findings associated with vomiting in children.
There are no other [[imaging]] findings associated with vomiting in children.
 
===Other Diagnostic Studies===
===Other Diagnostic Studies===


*There are no other imaging findings associated with vomiting in children.
*There are no other [[imaging]] findings associated with vomiting in children.


==Treatment==
==Treatment==
===Medical Therapy===
===Medical Therapy===


*The mainstay of therapy for vomiting in children is to treat underlying conditions and rehydration. Antiemesis drugs are used in the treatment on vomiting.
*The mainstay of therapy for vomiting in children is to treat underlying conditions and [[rehydration]]. [[Antiemetic]] can be used in the treatment of vomiting.<ref name="pmid22424648">{{cite journal| author=Carter B, Seupaul RA| title=Update: antiemetics for vomiting associated with acute gastroenteritis in children. | journal=Ann Emerg Med | year= 2012 | volume= 60 | issue= 3 | pages= e5-6 | pmid=22424648 | doi=10.1016/j.annemergmed.2012.01.031 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22424648  }} </ref>
*Hydration includes giving fluid in small amounts; [[electrolytes]] can be used in some situations as determined by the doctor to treat dehydration. Children with vomiting might stop oral intake and decompression of the stomach with a [[nasogastric tube]] necessary for a certain patient depending on the cause. Indications for [[nasogastric tube]] include [[duodenal atresia]], [[midgut malrotation]], [[volvulus]], [[jejunoileal atresia]], and [[meconium ileus]], [[necrotizing enterocolitis]], etc.<ref name="pmid23340985">{{cite journal| author=Singhi SC, Shah R, Bansal A, Jayashree M| title=Management of a child with vomiting. | journal=Indian J Pediatr | year= 2013 | volume= 80 | issue= 4 | pages= 318-25 | pmid=23340985 | doi=10.1007/s12098-012-0959-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23340985  }} </ref>
*A study shows that [[Ondasteron]] reduces required intravenous hydration by 51% and increase oral rehydration therapy in children with [[acute gastritis]] and [[acute gastroenteritis]].<ref name="pmid18006189">{{cite journal| author=Roslund G, Hepps TS, McQuillen KK| title=The role of oral ondansetron in children with vomiting as a result of acute gastritis/gastroenteritis who have failed oral rehydration therapy: a randomized controlled trial. | journal=Ann Emerg Med | year= 2008 | volume= 52 | issue= 1 | pages= 22-29.e6 | pmid=18006189 | doi=10.1016/j.annemergmed.2007.09.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18006189  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=19332600 Review in: Evid Based Med. 2009 Apr;14(2):44] </ref>
*Another [[antiemetic]]; [[metoclopramide]], often used in adults with refractory [[chemotherapy-induced nausea and vomiting]] (CIN V), is also used for CINV prevention in children. Regulatory bodies advised against its use in children aged <1 years and to caution against its use in children aged <5 years and its duration of service beyond five days.<ref name="pmid27003816">{{cite journal| author=Lau Moon Lin M, Robinson PD, Flank J, Sung L, Dupuis LL| title=The Safety of Metoclopramide in Children: A Systematic Review and Meta-Analysis. | journal=Drug Saf | year= 2016 | volume= 39 | issue= 7 | pages= 675-87 | pmid=27003816 | doi=10.1007/s40264-016-0418-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27003816  }} </ref>


===Surgery===
===Surgery===


*Surgical intervention is not recommended for the management of vomiting in children.
*[[Surgical]] intervention is not recommended for the management of vomiting in children.


===Prevention===
===Prevention===
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[[Category:Pediatrics]]
[[Category:Pediatrics]]
[[Category:Primary care]]
[[Category:Up-To-Date]]

Latest revision as of 15:12, 26 February 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Adenike Eketunde

Synonyms and keywords: Vomiting in kids

Overview

Vomiting in children is common and can range from a benign condition to a life-threatening condition. Most cases of vomiting are gastrointestinal in origin, most commonly gastroesophageal reflux disease and gastroenteritis. Vomiting, also known as emesis, is the oral expulsion of gastrointestinal content from the mouth due to the gut and thoracoabdominal wall muscles' contraction. At the same time, nausea refers to the need to vomit. Retching is used to describe the muscular event of vomiting with the expulsion of vomitus.

Historical Perspective

There is limited information about the historical perspective of vomiting in children.

Classification

Vomiting in children may be classified according to the content of vomitus, motion, and duration into:

Pathophysiology

Causes

Common causes of vomiting in children include:

Differentiating [disease name] from other Diseases

Vomiting in children must be differentiated from other diseases that cause vomiting in children such as cyclic vomiting syndrome (CVS) [7], gastrointestinal disease (obstructive and inflammatory) [8], central nervous system (CNS) disease, pulmonary disease, renal disease, endocrine/metabolic disorders, drugs (either as side effects or in Overdose), or psychiatric disorders.

Epidemiology and Demographics

Vomiting in children is very common and there are no racial, gender, age, or race predispstions to vomiting in children.

Risk Factors

There are no established risk factors for vomiting in children.

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

  • The diagnosis of vomiting in children is made with both medical history and physical examination.

Symptoms

  • Symptoms of vomiting in children include the following:

Physical Examination

  • Physical examination may be remarkable for signs of dehydration:

Laboratory Findings

  • There are no specific laboratory findings associated with vomiting in children. However, blood and urine tests are helpful in diagnosis to check for infection and kidney function.

Electrocardiogram

There are no ECG findings associated with vomiting in children.

X-ray

There are no x-ray findings associated with vomiting in children.

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with vomiting in children.

CT scan

There are no CT scan findings associated with vomiting in children.

MRI

There are no MRI findings associated with vomiting in children.

Other Imaging Findings

There are no other imaging findings associated with vomiting in children.

Other Diagnostic Studies

  • There are no other imaging findings associated with vomiting in children.

Treatment

Medical Therapy

Surgery

  • Surgical intervention is not recommended for the management of vomiting in children.

Prevention

  • There are no primary preventive measures available for vomiting in children.

References

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