PAEDIATRICS
VOMITING 4 WEEK OLD DDx
Duplicates - Merge with above!!
PromptPyloric Stenosis
ResponseUS - Target sign and thickendd pylorus (sn 95%)
Hypochloricaemic alkalosis (with increased creatinine)
Hypochloricaemic alkalosis (with increased creatinine)
PromptIncarcerated Hernia
ResponseIrribility with vomiting and inguinal mass
PromptIntussusception
ResponseUsually older age group 6-36 months. Can occur in neonates
Period of pallor, intermittent pain, with hematochezia
May have Dance sign (retraction in RIF)
Period of pallor, intermittent pain, with hematochezia
May have Dance sign (retraction in RIF)
PromptIntestinal duplication, stenosis or atresia
ResponseBilious vomiting if lesion at ampula of vater, and gastric or abdo distension (usually within horus or days of birth)
PromptAntral or duodenal web
ResponsePresentation depends on severity - vomiting and abdo distension
PromptHirsprung disease
ResponseAbdo distention and failure to pass meconium in first 48 hours. May present with enterocolitis
PromptForeign body
ResponseMore likely 6 months plus
Range of symptoms from asymptomatic through to food refusal, vomiting, perforation.
Range of symptoms from asymptomatic through to food refusal, vomiting, perforation.