Nausea and vomiting
Background
Clinical Features
Differential Diagnosis
By organ system
GI
- Peptic ulcer disease
- 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
- Head injury
- CVA
- Pseudotumor
- Hydrocephalus
- Mass lesion
- Meningitis
- Migraines
- Labyrinthitis
- Meniere disease
- Motion sickness
- Cannabinoid hyperemesis syndrome
Infectious
Drugs/Toxins
- Toxic doses
- Digoxin
- ASA
- APAP
- NSAIDs
- Opiates
- ETOH
- Anticonvulsants
- Antibiotics
- Antiarrhythmics
- Toxins
- Organophosphates
- CO
- Ricin
- Acute radiation syndrome
Endocrine
- Pregnancy
- Hyponatremia
- Adrenal insufficiency
- DKA
- Thyroid/parathyroid disorders
- Uremia
Miscellaneous
- ACS
- Gonadal torsion
- Nephrolithiasis
- Pain
- Acute glaucoma
- Anorexia/bulimia
- Depression
By Severity
Critical
- Boerhaave's
- 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 Disorders
Nonemergent
- Gastritis
- Gastroparesis
- PUD
- Gastroenteritis
- Biliary colic
- Hepatitis
- Thyroid
- Pregnancy
- Erythromycin
- Ibuprofen
- Chemotherapy
- Narcotics/wdwl from
- ETOH
- UTI
- Renal colic
- Motion sickness
- Labyrinthitis
Diagnosis
Work-Up
- CBC
- Chemistry
- Urine pregnancy
- LFTs
- Lipase
- APAP, ASA, digoxin levels
- UA
- ?Abd xray
- ?CT
- ?US
Evaluation
Management
Disposition
Complications
- Hypovolemia
- Metabolic alkalosis
- Hypokalemia
- Mallory-Weiss (tear)
- Boerhaave (rupture)
- Aspiration