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Flashcards in Peds GI Deck (17)
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What conditions is projectile vomiting associated with?

pyloric stenosis
increased intracranial pressure


What conditions is bilious vomiting associated with?

anatomic obstruction - surgical emergency


What does bloody vomiting suggest?

upper GI bleed


newborn with bilious or nonbilious vomiting, delayed passage of meconium past 24 hrs of life, lack of ganglion cells



newborn with bilious or nonbilious vomiting, possible pneumatosis (air in intestinal wall), commonly premature

necrotizing enterocolitis


0-3 month old, bilious vomiting, abdominal distension, KUB with paucity of bowel gas and corkscrew

malrotation with midgut volvulus - need emergency surgery


0-3 month old, nonbilious vomiting, emesis w/i 30 min of feeding, worse in supine

Gastroesophageal reflux - only concern if has pain, cough, poor weight gain


nonbilious vomiting, irritability, full anterior fontanelle, lethargy

child abuse


3-12 month old, non bilious vomiting may progress to bilious, probs diarrhea, low grade fever



3-12 month old, bilious vomiting, ab distension, paroxysms of ab pain followed by lethargy, air fluid levels or paucity of distal bowel gas on KUB, bloody stools, palpable sausage shaped mass in RUQ, crescent sign

intussusception - plain films, ultrasound, air contrast edema to diagnose
surgical management when not reduced with contrast enema


3-12 month old, nonbilious vomiting, anterior fontanelle fullness

intracranial mass lesion


fussy child during and after feedings, stereotypical movements of extension of head and stiffened extension of arms and legs

Sandifer syndrome - pain due to esophagitis from GER


4 week old, nonbilious vomiting, hungry infant, projectile vomiting, exam with palpable epigastric mass (olive), hypokalemic hypochloremic metabolic alkalosis

pyloric stenosis - need surgical pyloromyotomy, diagnosis by ultrasound of pyloris or upper GI series


excessive saliva, regurgitation, immediate nonbilious vomiting with first food, distension

esophageal atresia - diagnosis if attempt to pass catheter into stomach fails, CXR confirms, need surgical repair


periumbilical ab pain migrating to RLQ associated with nausea, vomiting and fever

classic presentation of appendicitis, less commonly seen in children


RLQ pain, vomiting, ab tenderness, guarding, elevated WBC, CRP, sterile pyuria

Appendicitis - diagnose by ultrasound or CT if US fails, broad spectrum antibiotics and surgical removal


palpable purpuric rash on lower extremities, colicky abdominal pain, vomiting,bloody stool, maybe arthritis or arthralgia, renal dz

HSP - supportive treatment, lasts 4 weeks