Vomiting in the Pediatric Age Group

Neil Mullen

Pediatr Health. 2009;3(5):479-503.

Abstract

Vomiting is a common complaint in any healthcare facility that deals with children. A child recently presented to our emergency department with an occult cause of vomiting, which led to the development of the following differential diagnosis of vomiting in children. Although usually of gastrointestinal origin, vomiting can be caused by the dysfunction of many different organ systems, the results of which may range from benign to life threatening. The differential diagnosis is presented in order of frequency, in order to make it as clinically relevant as possible, and then each section is further broken down to the pathophysiology, the historical facts, the pertinent physical examination findings, and the therapeutics of each diagnosis is discussed in variable detail.

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Table 1. Glasgow Coma Score/Pediatric Glasgow Coma Score.
Scale	Infant aged <1 year	Child aged 1-4 years	Age 4 years to adulthood
Eyes
4	Open	Open	Open
3	Open to voice	Open to voice	Open to voice
2	Open to pain	Open to pain	Open to pain
1	No response	No response	No response
Verbal
5	Coos, babbles	Oriented, speaks, interacts and social	Oriented and alert
4	Irritable cry, consolable	Confused speech, disoriented and consolable	Disoriented
3	Cries persistently to pain	Inappropriate words and inconsolable	Nonsensical speech
2	Moans to pain	Incomprehensible and agitated	Moans and unintelligible
1	No response	No response	No response
Motor
6	Normal, spontaneous movement	Normal, spontaneous movement	Follows commands
5	Withdraws to touch	Localizes pain	Localizes pain
4	Withdraws to pain	Withdraws to pain	Withdraws to pain
3	Decorticate flexion	Decorticate flexion	Decorticate flexion
2	Decerebrate extension	Decerebrate extension	Decerebrate extension
1	No response	No response	No response

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