Vomiting in the Young Child: Nothing or Nightmare

In this episode of Pediatric Emergency Playbook, Dr. Tim Horeczko discusses the critical causes of vomiting in young children, focusing on neonates, infants, and toddlers. He emphasizes the importance of differentiating vomiting from regurgitation and highlights malrotation with midgut volvulus as a dire condition in neonates, stressing the significance of bilious vomiting. The discussion extends to potential abuse as a cause of vomiting in infants, utilizing a six-question screening tool to identify at-risk children. Additionally, common conditions like intussusception and pyloric stenosis are reviewed. For toddlers and early school-age children, the episode covers acute gastroenteritis and the initial presentation of diabetic ketoacidosis (DKA), including key diagnostic criteria and management strategies, with a focus on avoiding cerebral edema. The episode concludes with a general approach to children presenting with vomiting, emphasizing a thorough history, physical exam, and judicious use of investigations.