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| | + | {{Adult top}} [[nausea and vomiting (peds)]].'' |
| | ==Background== | | ==Background== |
| | [[File:Nausea_and_vomiting.png|thumb|Nausea and Vomiting Algorithm]] | | [[File:Nausea_and_vomiting.png|thumb|Nausea and Vomiting Algorithm]] |
| − | ==Work-Up==
| |
| − | #CBC
| |
| − | #Chemistry
| |
| − | #Urine pregnancy
| |
| − | #LFTs
| |
| − | #Lipase
| |
| − | #APAP, ASA, digoxin levels
| |
| − | #UA
| |
| − | #?Abd xray
| |
| − | #?CT
| |
| − | #?US
| |
| | | | |
| − | == DDX by organ system == | + | ==Clinical Features== |
| − | ===GI===
| + | *Nausea and/or vomiting |
| − | #Peptic ulcer disease
| + | *Additional features of underlying process |
| − | #Obstruction
| |
| − | ##Adhesion
| |
| − | ##SBO/LBO
| |
| − | ##Gastric outlet obstruction
| |
| − | #Pancreatitis
| |
| − | #Gastroparesis
| |
| − | #Appendicitis
| |
| − | #Cholecystitis
| |
| − | #Cholangitis
| |
| − | #Hepatitis
| |
| − | #IBD
| |
| − | #Intussusception
| |
| − | #Tumor
| |
| − | #Strangulated hernia
| |
| − | #Volvulus
| |
| − | #Mesenteric ischemia
| |
| − | #Esophageal disorders (e.g. achalasia)
| |
| − | #Functional disorders
| |
| − | ##Psychogenic
| |
| − | ##IBS
| |
| − | #Pyloric stenosis
| |
| − | ===Neurologic===
| |
| − | #Head injury
| |
| − | #[[CVA]]
| |
| − | #Pseudotumor
| |
| − | #Hydrocephalus
| |
| − | #Mass lesion
| |
| − | #[[Meningitis]]
| |
| − | #Migraines
| |
| − | #[[Labyrinthitis]]
| |
| − | #Meniere disease
| |
| − | #Motion sickness
| |
| − | #[[Cannabinoid hyperemesis syndrome]]
| |
| | | | |
| − | ===Infectious=== | + | ==Differential Diagnosis== |
| − | #Bacterial toxins
| + | {{Nausea and vomiting DDX}} |
| − | #[[PNA]]
| |
| − | #[[SBP]]
| |
| − | #[[UTI]]
| |
| − | #Viruses (adeno, norwalk, rota
| |
| − | ===Drugs/Toxins===
| |
| − | #Toxic doses
| |
| − | ##Digoxin
| |
| − | ##ASA
| |
| − | ##APAP
| |
| − | #NSAIDs
| |
| − | #Opiates
| |
| − | #ETOH
| |
| − | #Anticonvulsants
| |
| − | #Abx
| |
| − | #Antiarrhythmics
| |
| − | #Toxins
| |
| − | ##Organophosphates
| |
| − | ##CO
| |
| − | ##Ricin
| |
| − | ===Endocrine===
| |
| − | #Pregnancy
| |
| − | #[[Hyponatremia]]
| |
| − | #Adrenal insufficiency
| |
| − | #[[DKA]]
| |
| − | #Thyroid/parathyroid disorders
| |
| − | #[[Uremia]]
| |
| | | | |
| − | ===Miscellaneous=== | + | ===By organ system=== |
| − | #[[ACS]]
| + | ====GI==== |
| − | #Gonadal torsion
| + | *[[Peptic ulcer disease]] |
| − | #[[Nephrolithiasis]]
| + | *[[Bowel obstruction|Obstruction]] |
| − | #Pain
| + | **Adhesion |
| − | #Acute glaucoma
| + | **[[Small bowel obstruction]]/LBO |
| − | #Anorexia/bulimia
| + | ***[[SMA syndrome]] |
| − | #Depression
| + | **Gastric outlet obstruction |
| | + | **[[Gastric volvulus]] |
| | + | **[[Bezoar]] |
| | + | *[[Pancreatitis]] |
| | + | *[[Gastroparesis]] |
| | + | *[[Appendicitis]] |
| | + | *[[Cholecystitis]] |
| | + | *[[Cholangitis]] |
| | + | *[[Acute Hepatitis]] |
| | + | *[[IBD]] |
| | + | *[[Intussusception]] |
| | + | *Tumor |
| | + | *Strangulated [[hernia]] |
| | + | *[[Volvulus]] |
| | + | *[[Mesenteric ischemia]] |
| | + | *Esophageal disorders (e.g. [[achalasia]]) |
| | + | *Functional disorders |
| | + | **Psychogenic |
| | + | **[[IBS]] |
| | + | *[[Pyloric Stenosis]] |
| | | | |
| − | ==DDx by Severity== | + | ====Neurologic==== |
| − | === Critical === | + | *[[Head injury]] |
| − | #[[Esophageal Perforation|Boerhaave's]]
| + | *[[CVA]] |
| − | #Ischemic bowel
| + | *[[Idiopathic intracranial hypertension]] |
| − | #[[ICH]]
| + | *[[Hydrocephalus]] |
| − | #[[Meningitis]]
| + | *[[Intracranial mass|Mass lesion]] |
| − | #[[DKA]]
| + | *[[Meningitis]] |
| − | #[[AMI]]
| + | *[[Migraine]] |
| − | #[[Sepsis]]
| + | *[[Labyrinthitis]] |
| | + | *[[Meniere's disease]] |
| | + | *[[Motion sickness]] |
| | + | *[[Cannabinoid hyperemesis syndrome]] |
| | | | |
| − | === Emergent === | + | ====Infectious==== |
| − | #Gastric outlet obstruction
| + | *[[Bacteria]]l toxins |
| − | #[[Pancreatitis]]
| + | *[[Pneumonia]] |
| − | #[[Cholecystitis]]
| + | *[[SBP]] |
| − | #Bowel obstruction/ileus
| + | *[[UTI]] |
| − | #Ruptured viscus
| + | *Viruses ([[adenovirus]], [[norovirus]], [[rotavirus]]) |
| − | #[[Appendicitis]]
| |
| − | #Peritonitis
| |
| − | #Migraine
| |
| − | #CNS tumor
| |
| − | #raised ICP
| |
| − | #Adrenal insuffciency
| |
| − | #Hyperemesis gravidarum
| |
| − | #Tylenol
| |
| − | #Digoxin
| |
| − | #ASA
| |
| − | #Theophyline
| |
| − | #Gonadal torsion
| |
| − | #CO
| |
| − | #[[Electrolyte Disorders]]
| |
| − | ===Nonemergent===
| |
| − | #[[Gastritis]]
| |
| − | #Gastroparesis
| |
| − | #PUD
| |
| − | #Gastroenteritis
| |
| − | #Biliary colic
| |
| − | #Hepatitis
| |
| − | #Thyroid
| |
| − | #Pregnancy
| |
| − | #Erythromycin
| |
| − | #Ibuprofen
| |
| − | #Chemotherapy
| |
| − | #Narcotics/wdwl from
| |
| − | #ETOH
| |
| − | #UTI
| |
| − | #Renal colic
| |
| − | #Motion sickness
| |
| − | #Labyrinthitis
| |
| | | | |
| − | == Complications == | + | ====Drugs/Toxins==== |
| − | #Hypovolemia
| + | *Toxic doses |
| − | #Metabolic alkalosis
| + | **[[Digoxin toxicity]] |
| − | #Hypokalemia
| + | **[[Aspirin toxicity]] |
| − | #Mallory-Weiss (tear)
| + | **[[Acetaminophen toxicity]] |
| − | #Boerhaave (rupture)
| + | **[[Ipecac toxicity]] |
| − | #Aspiration
| + | *[[NSAIDs]] |
| | + | *[[Opioids]] |
| | + | *[[Alcohol]] |
| | + | *[[Anticonvulsants]] |
| | + | *[[Antibiotics]] |
| | + | *[[Antiarrhythmics]] |
| | + | *Toxins |
| | + | **[[Organophosphates]] |
| | + | **[[Carbon monoxide]] |
| | + | **[[Ricin]] |
| | + | *[[Acute radiation syndrome]] |
| | | | |
| − | == Peds == | + | ====Endocrine==== |
| | + | *[[Pregnancy]], [[hyperemesis gravidarum]] |
| | + | *[[Hyponatremia]] |
| | + | *[[Adrenal insufficiency]] |
| | + | *[[DKA]] |
| | + | *[[Thyroid]]/parathyroid disorders |
| | + | *[[Uremia]] |
| | | | |
| − | {| cellspacing="1" cellpadding="3" border="0" bgcolor="#666666" width="100%"
| + | ====Miscellaneous==== |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| + | *[[ACS]] |
| − | | valign="top" bgcolor="#ffffff" class="font12" colspan="2" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | '''Newborn'''
| + | *[[Ovarian torsion|ovarian]]/[[testicular torsion]] |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| + | *[[Nephrolithiasis]] |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Obstructive intestinal anomalies
| + | *Pain |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Esophageal stenosis/atresia, pyloric stenosis, intestinal stenosis/atresia, malrotation ± volvulus, incarcerated hernia, meconium ileus/plug, Hirschsprung disease, imperforate anus, enteric duplications
| + | *[[Acute angle-closure glaucoma]] |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| + | *[[Anorexia nervosa]]/[[bulimia nervosa]] |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Neurologic
| + | *[[Depression]] |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Intracranial bleed/mass, hydrocephalus, cerebral edema, kernicterus
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Renal
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Urinary tract infection, obstructive uropathy, renal insufficiency
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Infectious
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Viral illness, gastroenteritis, meningitis, sepsis
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Metabolic/endocrine
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Inborn errors of metabolism (urea cycle, amino/organic acid, carbohydrate), congenital adrenal hyperplasia
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Miscellaneous
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Ileus, gastroesophageal reflux, necrotizing enterocolitis, milk allergy, GI perforation
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" colspan="2" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | '''Infant (<12 mo)'''
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Obstructive intestinal anomalies
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Pyloric stenosis, malrotation ± volvulus, incarcerated hernia, Hirschsprung disease, enteric duplications, intussusception, foreign body, bezoars, Meckel diverticulum
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Neurologic
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Intracranial bleed/mass, hydrocephalus, cerebral edema
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Renal
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Urinary tract infection, obstructive uropathy, renal insufficiency
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Infectious
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Viral illness, gastroenteritis, meningitis, sepsis, otitis media, pneumonia, pertussis, hepatitis
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Metabolic/endocrine
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Inborn errors of metabolism, adrenal insufficiency, renal tubular acidosis
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Miscellaneous
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Ileus, gastroesophageal reflux, post-tussive, peritonitis, drug overdose
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | '''Child (>12 mo)'''
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " |
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Obstructive intestinal anomalies
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Malrotation ± volvulus, incarcerated hernia, Hirschsprung disease, intussusception, foreign body, bezoars, Meckel diverticulum, acquired esophageal stricture, peptic ulcer disease, adhesions, superior mesenteric artery syndrome
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Neurologic
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Intracranial bleed/mass, cerebral edema, postconcussive, migraine | |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Renal
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Urinary tract infection, obstructive uropathy, renal insufficiency
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Infectious
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Viral illness, gastroenteritis, meningitis, sepsis, otitis media, pneumonia, hepatitis, streptococcal pharyngitis
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Metabolic/endocrine
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Inborn errors of metabolism, adrenal insufficiency, renal tubular acidosis, diabetes mellitus, Reye syndrome, porphyria
| |
| − | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Miscellaneous
| |
| − | | valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Ileus, gastroesophageal reflux, post-tussive, peritonitis, drug overdose, appendicitis, pancreatitis, gastritis, Crohn disease, pregnancy, psychogenic, cyclic vomiting syndrome
| |
| − | |}
| |
| | | | |
| − | == Source == | + | ==Evaluation== |
| − | *Rosen | + | ''Varies widely depending on clinical presentation'' |
| − | *Tintinalli | + | *CBC |
| | + | *Chemistry |
| | + | *Urine pregnancy |
| | + | *[[LFTs]] |
| | + | *Lipase |
| | + | *APAP, ASA, digoxin levels |
| | + | *[[Urinalysis]] |
| | + | *?[[Abdominal xray]] |
| | + | *?CT |
| | + | *?[[Ultrasound]] |
| | + | |
| | + | ==Management== |
| | + | *Treat underlying pathology |
| | + | *Address [[electrolyte derangements]] and [[dehydration]] as needed |
| | + | *[[Antiemetics]] |
| | + | |
| | + | ==Disposition== |
| | + | *Depends on cause |
| | + | *Most non-specific episodes of acute nausea and vomiting may be discharged, if: |
| | + | **No emergent/urgent cause identified or suspected |
| | + | **Patient tolerating fluids after treatment |
| | + | |
| | + | ==Complications== |
| | + | *[[Hypovolemia]] |
| | + | *[[Metabolic alkalosis]] |
| | + | *[[Hypokalemia]] |
| | + | *[[Mallory-Weiss]] (tear) |
| | + | *[[Boerhaave]] (rupture) |
| | + | *Aspiration |
| | + | |
| | + | ==See Also== |
| | + | *[[Nausea and vomiting (peds)]] |
| | + | |
| | + | ==External Links== |
| | + | |
| | + | ==References== |
| | + | <references/> |
| | | | |
| | [[Category:GI]] | | [[Category:GI]] |
| − | [[Category:Peds]] | + | [[Category:Symptoms]] |
