Kaylan Ray Parashette and Joseph Croffie
Pediatrics in Review 2013;34;307 DOI: 10.1542/pir.34-7-307

Vomiting | MacKoul Pediatrics Cape Coral FloridaVomiting is the forceful release of stomach contents by muscular contraction. Vomiting is highly variable and may indicate a mild acute viral illness to a life-threatening condition. Vomiting can be categorized based on content, color, timing and other associated symptoms. The ability to recognize certain red flags helps distinguish the cause of vomiting.

Vomiting is either considered nonbilious or bilious. Bilious refers to the presence of bile and appears light to dark green in color and usually means a blockage of the bile duct (response for release of enzymes into the small intestine) and considered emergent.

The presence of blood in vomit is also considered emergent. Bright red blood usually indicated an upper intestinal bleed (peptic ulcer disease, gastritis, esophagitis) while the presence of coffee-grounds means blood has been in contact with gastric acid and indicates a lower intestinal bleed.

Vomiting is described as nonprojectile or projectile. Projectile vomiting of more than 5 feet indicated an obstruction of gastric outlet. If present in newborns from 3-6 weeks old, may indicate pyloric stenosis.

Vomiting during the night with or without coughing may be associated with seasonal allergies or acid reflux.

An early morning headache with vomiting that projectile usually indicates increased intracranial pressure and considered emergent.

A fever more than 72 hours in a child that appears ill, younger 6 months of age could mean serious bacterial infection.

Vomiting with localized abdominal pain such as the right lower quadrant may indicate appendicitis, right upper quadrant gallbladder infections/gallstones.

Poor weight gain or weight loss associated with vomiting may indicated underlying chronic disease such as irritable bowel disease, celiac disease or other metabolic diseases.

About author MacKoul Pediatrics

MacKoul Pediatrics is an amazing local pediatrics office in Cape Coral, FL where caring, compassionate doctors and nurses work with you to keep your children as healthy as possible. MacKoul cares for children from birth to college age, from Cape Coral, Fort Myers, Naples, and beyond.

January 29, 2014