Nausea and vomiting
Complications
- Hypovolemia
- Metabolic alkalosis
- Hypokalemia
- Mallory-Weiss (tear)
- Boerhaave (rupture)
- Aspiration
DDX
Critical
- Boerhaave
- Ischemic bowel
- ICH
- Meningitis
- DKA
- AMI
- Sepsis
Emergent
- Gastric outlet obstruction
- Pancreatitis
- Cholecystitis
- Bowel obstruction/ileus
- Ruptured viscus
- Appendicitis
- Peritonitis
- Migraine
- CNS tumor
- raised ICP
- Adrenal insuffciency
- Hyperemesis gravidarum
- Tylenol
- Digoxin
- ASA
- Theophyline
- Gonadal torsion
- CO
- Electrolyte disorder
Nonemergent
- Gastritis
- Gastroparesis
- PUD
- Gastroenteritis
- Biliary colic
- Hepatitis
- Thyroid
- Pregnancy
- Erythromycin
- Ibuprofen
- Chemotherapy
- Narcotics/wdwl from
- ETOH
- UTI
- Renal colic
- Motion sickness
- Labyrinthitis
Peds
Newborn | |
Obstructive intestinal anomalies | Esophageal stenosis/atresia, pyloric stenosis, intestinal stenosis/atresia, malrotation ± volvulus, incarcerated hernia, meconium ileus/plug, Hirschsprung disease, imperforate anus, enteric duplications |
Neurologic | Intracranial bleed/mass, hydrocephalus, cerebral edema, kernicterus |
Renal | Urinary tract infection, obstructive uropathy, renal insufficiency |
Infectious | Viral illness, gastroenteritis, meningitis, sepsis |
Metabolic/endocrine | Inborn errors of metabolism (urea cycle, amino/organic acid, carbohydrate), congenital adrenal hyperplasia |
Miscellaneous | Ileus, gastroesophageal reflux, necrotizing enterocolitis, milk allergy, GI perforation |
Infant (<12 mo) | |
Obstructive intestinal anomalies | Pyloric stenosis, malrotation ± volvulus, incarcerated hernia, Hirschsprung disease, enteric duplications, intussusception, foreign body, bezoars, Meckel diverticulum |
Neurologic | Intracranial bleed/mass, hydrocephalus, cerebral edema |
Renal | Urinary tract infection, obstructive uropathy, renal insufficiency |
Infectious | Viral illness, gastroenteritis, meningitis, sepsis, otitis media, pneumonia, pertussis, hepatitis |
Metabolic/endocrine | Inborn errors of metabolism, adrenal insufficiency, renal tubular acidosis |
Miscellaneous | Ileus, gastroesophageal reflux, post-tussive, peritonitis, drug overdose |
Child (>12 mo) | |
Obstructive intestinal anomalies | Malrotation ± volvulus, incarcerated hernia, Hirschsprung disease, intussusception, foreign body, bezoars, Meckel diverticulum, acquired esophageal stricture, peptic ulcer disease, adhesions, superior mesenteric artery syndrome |
Neurologic | Intracranial bleed/mass, cerebral edema, postconcussive, migraine |
Renal | Urinary tract infection, obstructive uropathy, renal insufficiency |
Infectious | Viral illness, gastroenteritis, meningitis, sepsis, otitis media, pneumonia, hepatitis, streptococcal pharyngitis |
Metabolic/endocrine | Inborn errors of metabolism, adrenal insufficiency, renal tubular acidosis, diabetes mellitus, Reye syndrome, porphyria |
Miscellaneous | Ileus, gastroesophageal reflux, post-tussive, peritonitis, drug overdose, appendicitis, pancreatitis, gastritis, Crohn disease, pregnancy, psychogenic, cyclic vomiting syndrome |
Source
Rosen, Tintinalli