Vomitus:
(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.
