Nausea and vomiting: Difference between revisions
m (Rossdonaldson1 moved page Nausea and Vomiting to Nausea and vomiting over redirect) |
No edit summary |
||
Line 2: | Line 2: | ||
[[File:Nausea_and_vomiting.png|thumb|Nausea and Vomiting Algorithm]] | [[File:Nausea_and_vomiting.png|thumb|Nausea and Vomiting Algorithm]] | ||
==Work-Up== | ==Work-Up== | ||
*CBC | |||
*Chemistry | |||
*Urine pregnancy | |||
*LFTs | |||
*Lipase | |||
*APAP, ASA, digoxin levels | |||
*UA | |||
*?Abd xray | |||
*?CT | |||
*?US | |||
== DDX by organ system == | == DDX by organ system == | ||
===GI=== | ===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=== | ===Neurologic=== | ||
*Head injury | |||
*[[CVA]] | |||
*Pseudotumor | |||
*Hydrocephalus | |||
*Mass lesion | |||
*[[Meningitis]] | |||
*Migraines | |||
*[[Labyrinthitis]] | |||
*Meniere disease | |||
*Motion sickness | |||
*[[Cannabinoid hyperemesis syndrome]] | |||
===Infectious=== | ===Infectious=== | ||
*Bacterial toxins | |||
*[[PNA]] | |||
*[[SBP]] | |||
*[[UTI]] | |||
*Viruses (adeno, norwalk, rota | |||
===Drugs/Toxins=== | ===Drugs/Toxins=== | ||
*Toxic doses | |||
**Digoxin | |||
**ASA | |||
**APAP | |||
*NSAIDs | |||
*Opiates | |||
*ETOH | |||
*Anticonvulsants | |||
*Abx | |||
*Antiarrhythmics | |||
*Toxins | |||
**Organophosphates | |||
**CO | |||
**Ricin | |||
===Endocrine=== | ===Endocrine=== | ||
*Pregnancy | |||
*[[Hyponatremia]] | |||
*Adrenal insufficiency | |||
*[[DKA]] | |||
*Thyroid/parathyroid disorders | |||
*[[Uremia]] | |||
===Miscellaneous=== | ===Miscellaneous=== | ||
*[[ACS]] | |||
*Gonadal torsion | |||
*[[Nephrolithiasis]] | |||
*Pain | |||
*Acute glaucoma | |||
*Anorexia/bulimia | |||
*Depression | |||
==DDx by Severity== | ==DDx by Severity== | ||
=== Critical === | === Critical === | ||
*[[Esophageal Perforation|Boerhaave's]] | |||
*Ischemic bowel | |||
*[[ICH]] | |||
*[[Meningitis]] | |||
*[[DKA]] | |||
*[[AMI]] | |||
*[[Sepsis]] | |||
=== Emergent === | === 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=== | ===Nonemergent=== | ||
*[[Gastritis]] | |||
*Gastroparesis | |||
*PUD | |||
*Gastroenteritis | |||
*Biliary colic | |||
*Hepatitis | |||
*Thyroid | |||
*Pregnancy | |||
*Erythromycin | |||
*Ibuprofen | |||
*Chemotherapy | |||
*Narcotics/wdwl from | |||
*ETOH | |||
*UTI | |||
*Renal colic | |||
*Motion sickness | |||
*Labyrinthitis | |||
== Complications == | == Complications == | ||
*Hypovolemia | |||
*Metabolic alkalosis | |||
*Hypokalemia | |||
*Mallory-Weiss (tear) | |||
*Boerhaave (rupture) | |||
*Aspiration | |||
== Peds == | == Peds == | ||
{| cellspacing="1" cellpadding="3" border="0" bgcolor=" | {| cellspacing="1" cellpadding="3" border="0" bgcolor="*666666" width="100%" | ||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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''' | ||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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 | ||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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 | ||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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)''' | ||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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)''' | ||
| valign="top" bgcolor=" | | 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; " | | ||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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; " | |- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | ||
| valign="top" bgcolor=" | | 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=" | | 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 | ||
|} | |} | ||
== | == References == | ||
[[Category:GI]] | [[Category:GI]] | ||
[[Category:Peds]] | [[Category:Peds]] |
Revision as of 15:28, 23 June 2015
Background
Work-Up
- CBC
- Chemistry
- Urine pregnancy
- LFTs
- Lipase
- APAP, ASA, digoxin levels
- UA
- ?Abd xray
- ?CT
- ?US
DDX 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
- Abx
- Antiarrhythmics
- Toxins
- Organophosphates
- CO
- Ricin
Endocrine
- Pregnancy
- Hyponatremia
- Adrenal insufficiency
- DKA
- Thyroid/parathyroid disorders
- Uremia
Miscellaneous
- ACS
- Gonadal torsion
- Nephrolithiasis
- Pain
- Acute glaucoma
- Anorexia/bulimia
- Depression
DDx 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
Complications
- Hypovolemia
- Metabolic alkalosis
- Hypokalemia
- Mallory-Weiss (tear)
- Boerhaave (rupture)
- Aspiration
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 |