Viral gastroenteritis: Difference between revisions
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''See [[Acute gastroenteritis (peds)]] for pediatric patients'' | ''See [[Acute gastroenteritis (peds)]] for pediatric patients'' | ||
==Background== | ==Background== | ||
*Most common cause of acute gastroenteritis (AGE) | *Most common cause of [[acute gastroenteritis]] (AGE) | ||
*Viral gastroenteritis usually lasts <7d | *Viral gastroenteritis usually lasts <7d | ||
*Do NOT diagnosis isolated vomiting as AGE! | *Do NOT diagnosis isolated vomiting as AGE! | ||
Revision as of 19:05, 10 August 2016
See Acute gastroenteritis (peds) for pediatric patients
Background
- Most common cause of acute gastroenteritis (AGE)
- Viral gastroenteritis usually lasts <7d
- Do NOT diagnosis isolated vomiting as AGE!
Clinical Features
- Vomiting
- Watery, non-bloody diarrhea
- Crampy/diffuse abdominal pain
- Features that suggest non-viral etiology:
Differential Diagnosis
Diffuse Abdominal pain
- Abdominal aortic aneurysm
- Acute gastroenteritis
- Aortoenteric fisulta
- Appendicitis (early)
- Bowel obstruction
- Bowel perforation
- Diabetic ketoacidosis
- Gastroparesis
- Hernia
- Hypercalcemia
- Inflammatory bowel disease
- Mesenteric ischemia
- Pancreatitis
- Peritonitis
- Sickle cell crisis
- Spontaneous bacterial peritonitis
- Volvulus
Nausea and vomiting
Critical
Emergent
- Acute radiation syndrome
- Acute gastric dilation
- Adrenal insufficiency
- Appendicitis
- Bowel obstruction/ileus
- Carbon monoxide poisoning
- Cholecystitis
- CNS tumor
- Electrolyte abnormalities
- Elevated ICP
- Gastric outlet obstruction, gastric volvulus
- Hyperemesis gravidarum
- Medication related
- Pancreatitis
- Peritonitis
- Ruptured viscus
- Testicular torsion/ovarian torsion
Nonemergent
- Acute gastroenteritis
- Biliary colic
- Cannabinoid hyperemesis syndrome
- Chemotherapy
- Cyclic vomiting syndrome
- ETOH
- Gastritis
- Gastroenteritis
- Gastroparesis
- Hepatitis
- Labyrinthitis
- Migraine
- Medication related
- Motion sickness
- Narcotic withdrawal
- Thyroid
- Pregnancy
- Peptic ulcer disease
- Renal colic
- UTI
Evaluation
- Assess hydration status
- Cap refill, skin turgor, respiratory rate
- Consider stool studies if:
- >10 stools in previous 24hr
- Travel to high-risk country
- Fever
- Bloody stool
- Persistent diarrhea
Management
- Rehydration (PO preferred)
- 30mL(1oz)/kg/hr
- Reduced-osmolarity oral rehydration solution
- Antiemetic
- Ondansetron 0.15mg/kg/dose IV/PO
- May worsen diarrhea
Disposition
- Most can be discharged
- Admit
- Unable to tolerate PO
- Hemodynamic instability
- Significant comorbidities