Presentation

Vomiting

Key Conditions

Key conditions are the core conditions that the Paediatric Undergraduate and Clerkship Directors of Canada (PUPDOC) felt are essential for graduating medical students to know. The Key Conditions are neither a differential diagnosis nor a clinical approach. They highlight conditions that may be unique to paediatrics, that are essential, or that are common. Key Conditions can present in a number of ways – each is listed as under the most common Clinical Presentation.

Clinical Approach

Clinical approaches represent one of many methods to think through a clinical presentation, and narrow down a differential diagnosis. There are many conditions that can present with similar symptomatology. These presentations are not meant to contain an exhaustive list of differential diagnoses, but rather outline how to think through patient signs and symptoms, and understand some of the most common and important Paediatric conditions. There are many different ways to approach any clinical presentation, and these approaches are not meant to replace clinical judgement.

Vignette

A 2month old girl is brought into the emergency department due to vomiting starting 3 days ago, and has worsened over the last 24 hours

Diagrams

Pre-Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Lectures

Small Groups

Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Objectives

By the end of the Paediatric Clerkship, a medical student will be able to:

  1. Describe metabolic and electrolyte abnormalities that occur with vomiting.
  2. Recognize the clinical features and propose a management plan for patients with gastroesophageal reflux / gastroesophageal reflux disease, intussusception, malrotation / volvulus, and pyloric stenosis.
  3. Recognize the clinical features of intestinal atresia.

Half Day Cases

  • A 5 week old child is brought into the emergency department due to vomiting. He has had reflux since he was first born, but the emesis is getting more forceful. The vomit is non-bilious and non-bloody. He vomits with ever feed, and seems very hungry afterwards
  • A 2 day old infant is in the newborn nursery. The patient has developed bilious emesis.
  • A 5 year old child presents to the emergency department with severe abdominal pain, that is not alleviated by position or medication. She has developed vomiting over the last 4 hours as well

Resources

The following resources have been reviewed and collated by canuc-paeds. These resources are aimed to provide information at the level of the medical student. These include overviews of topics, clinical resources, and useful guidelines that contain relevant materials.

Papers 

  • Vomiting. Parashette KR et al. .
    Pediatrics in Review 2013; 4: 307.
    Review article on vomiting. Comprehensive review of vomiting; age specific including the older child. Discussion of organic and non-organic causes of vomiting. .

Videos 

No videos.