Approach consider: infection, inflammation, mechanical obstruction, motility disorders, others (e.g. eating disorder) Non GI caus...
Approach
- consider: infection, inflammation, mechanical obstruction, motility disorders, others (e.g. eating disorder)
- Non GI causes: CNS, UTI, systemic infections, others
History
- age of onset, duration, severity
- quality: bilious, bloody, regurgitation
- associated symptoms e.g. fever, abdominal pain
- effect on growth and development, concurrent disease
physical exam: assess hydration
lab investigation
- bloody emesis: investigate for causes of upper GI bleed
- bilious emesis: rule out obstruction (upper GI series, U/S)
- regurgitation: evaluate for reflux (barium swallow with fluoroscopy, 24 hour esophageal pH probe)
useful tests (based on history and physical exam)
- CBC, lytes, BUN, Cr, ESR
- urine, blood, stool C&S
- amylase, lipase
- arterial blood gases
- abdominal x-ray, ultrasound, contrast radiology
- endoscopy
management
- treat the underlying cause
- rehydration
