The presence of certain clinical findings in a child with recurrent vomiting may indicate that a potentially serious underlying condition may be present.



(1) bilious

(2) forceful (projectile)

(3) onset after 6 months of age


Gastrointestinal findings:

(1) bleeding (hematemesis, hematochezia)

(2) diarrhea

(3) constipation

(4) abdominal tenderness and/or distension


Neurologic findings:

(1) seizures

(2) lethargy or stupor

(3) bulging fontanelles

(4) macrocephaly or microcephaly


Other physical findings:

(1) failure to thrive

(2) fever

(3) hepatosplenomegaly


Other diagnoses:

(1) genetic disorder (Trisomy, other chromosomal disorder)

(2) other congenital disorder (infection, malformation, etc.)

(3) family history of metabolic disorder


The presence of one or more of these findings should prompt a thorough evaluation of the infant.


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