Difference between revisions of "Nausea and vomiting"

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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
 
##[[Small bowel obstruction]]/LBO
 
##Gastric outlet obstruction
 
#[[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]]
 
  
===Neurologic===
+
==Differential Diagnosis==
#Head injury
+
{{Nausea and vomiting DDX}}
#[[CVA]]
 
#Pseudotumor
 
#Hydrocephalus
 
#Mass lesion
 
#[[Meningitis]]
 
#Migraines
 
#[[Labyrinthitis]]
 
#Meniere disease
 
#Motion sickness
 
#[[Cannabinoid hyperemesis syndrome]]
 
  
===Infectious===
+
===By organ system===
#Bacterial toxins
+
====GI====
#[[PNA]]
+
*[[Peptic ulcer disease]]
#[[SBP]]
+
*[[Bowel obstruction|Obstruction]]
#[[UTI]]
+
**Adhesion
#Viruses (adeno, norwalk, rota
+
**[[Small bowel obstruction]]/LBO
===Drugs/Toxins===
+
***[[SMA syndrome]]
#Toxic doses
+
**Gastric outlet obstruction
##Digoxin
+
**[[Gastric volvulus]]
##ASA
+
**[[Bezoar]]
##APAP
+
*[[Pancreatitis]]
#NSAIDs
+
*[[Gastroparesis]]
#Opiates
+
*[[Appendicitis]]
#ETOH
+
*[[Cholecystitis]]
#Anticonvulsants
+
*[[Cholangitis]]
#Abx
+
*[[Acute Hepatitis]]
#Antiarrhythmics
+
*[[IBD]]
#Toxins
+
*[[Intussusception]]
##Organophosphates
+
*Tumor
##CO
+
*Strangulated [[hernia]]
##Ricin
+
*[[Volvulus]]
===Endocrine===
+
*[[Mesenteric ischemia]]
#Pregnancy
+
*Esophageal disorders (e.g. [[achalasia]])
#[[Hyponatremia]]
+
*Functional disorders
#Adrenal insufficiency
+
**Psychogenic
#[[DKA]]
+
**[[IBS]]
#Thyroid/parathyroid disorders
+
*[[Pyloric Stenosis]]
#[[Uremia]]
 
  
===Miscellaneous===
+
====Neurologic====
#[[ACS]]
+
*[[Head injury]]
#Gonadal torsion
+
*[[CVA]]
#[[Nephrolithiasis]]
+
*[[Idiopathic intracranial hypertension]]
#Pain
+
*[[Hydrocephalus]]
#Acute glaucoma
+
*[[Intracranial mass|Mass lesion]]
#Anorexia/bulimia
+
*[[Meningitis]]
#Depression
+
*[[Migraine]]
 +
*[[Labyrinthitis]]
 +
*[[Meniere's disease]]
 +
*[[Motion sickness]]
 +
*[[Cannabinoid hyperemesis syndrome]]
  
==DDx by Severity==
+
====Infectious====
=== Critical ===
+
*[[Bacteria]]l toxins
#[[Esophageal Perforation|Boerhaave's]]
+
*[[Pneumonia]]
#Ischemic bowel
+
*[[SBP]]
#[[ICH]]
+
*[[UTI]]
#[[Meningitis]]
+
*Viruses ([[adenovirus]], [[norovirus]], [[rotavirus]])
#[[DKA]]
 
#[[AMI]]
 
#[[Sepsis]]
 
  
=== Emergent ===
+
====Drugs/Toxins====
#Gastric outlet obstruction
+
*Toxic doses
#[[Pancreatitis]]
+
**[[Digoxin toxicity]]
#[[Cholecystitis]]
+
**[[Aspirin toxicity]]
#Bowel obstruction/ileus
+
**[[Acetaminophen toxicity]]
#Ruptured viscus
+
**[[Ipecac toxicity]]
#[[Appendicitis]]
+
*[[NSAIDs]]
#Peritonitis
+
*[[Opioids]]
#Migraine
+
*[[Alcohol]]
#CNS tumor
+
*[[Anticonvulsants]]
#raised ICP
+
*[[Antibiotics]]
#Adrenal insuffciency
+
*[[Antiarrhythmics]]
#Hyperemesis gravidarum
+
*Toxins
#Tylenol
+
**[[Organophosphates]]
#Digoxin
+
**[[Carbon monoxide]]
#ASA
+
**[[Ricin]]
#Theophyline
+
*[[Acute radiation syndrome]]
#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 ==
+
====Endocrine====
#Hypovolemia
+
*[[Pregnancy]], [[hyperemesis gravidarum]]
#Metabolic alkalosis
+
*[[Hyponatremia]]
#Hypokalemia
+
*[[Adrenal insufficiency]]
#Mallory-Weiss (tear)
+
*[[DKA]]
#Boerhaave (rupture)
+
*[[Thyroid]]/parathyroid disorders
#Aspiration
+
*[[Uremia]]
  
== Peds ==
+
====Miscellaneous====
 +
*[[ACS]]
 +
*[[Ovarian torsion|ovarian]]/[[testicular torsion]]
 +
*[[Nephrolithiasis]]
 +
*Pain
 +
*[[Acute angle-closure glaucoma]]
 +
*[[Anorexia nervosa]]/[[bulimia nervosa]]
 +
*[[Depression]]
  
{| cellspacing="1" cellpadding="3" border="0" bgcolor="#666666" width="100%"
+
==Evaluation==
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
+
''Varies widely depending on clinical presentation''
| 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''' 
+
*CBC
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
+
*Chemistry
| 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
+
*Urine pregnancy
| 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
+
*[[LFTs]]
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
+
*Lipase
| 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
+
*APAP, ASA, digoxin levels
| 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
+
*[[Urinalysis]]
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
+
*?[[Abdominal xray]]
| 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
+
*?CT
| 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
+
*?[[Ultrasound]]
|- 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)'''&nbsp;
 
|- 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)'''&nbsp;
 
| 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; " | &nbsp;
 
|- 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 ==
+
==Management==
*Rosen
+
*Treat underlying pathology
*Tintinalli
+
*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]]

Latest revision as of 05:59, 14 May 2020

This page is for adult patients. For pediatric patients, see: nausea and vomiting (peds).

Background

Nausea and Vomiting Algorithm

Clinical Features

  • Nausea and/or vomiting
  • Additional features of underlying process

Differential Diagnosis

Nausea and vomiting

Critical

Emergent

Nonemergent

By organ system

GI

Neurologic

Infectious

Drugs/Toxins

Endocrine

Miscellaneous

Evaluation

Varies widely depending on clinical presentation

Management

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

See Also

External Links

References