1. A Vomiting Child Sariu Ali:

2. Introduction Vomiting is a symptom, presenting complaint in multitude of disorders Range from gastrointestinal pathology to disease in distant organ (otitis media or intracranial lesion) In children, especially infants, must distinguish from regurgitation – effortless expulsion of gastric contents

5. Common causes of vomiting

6. Rare causes of vomiting

7. Causes of Vomiting by systems

8. Causes of Vomiting by systems

10. Duration /Frequency

11. Onset

12. Associated with food intake

13. instantly : esophageal obstruction

14. After a while : stomach or duodenal obstruction

15. Nature (projectile / non projectile)

16. Color and contents

17. Non digested food :proximal obstruction

18. Semi digested food : distal obstruction

19. Billous content : distal to 2nd part of duodenum

20. Fecal material : obstruction at the large intestine

21. Associated symptoms

23. Urinary– dysuria,hematuria

24. CNS – irritability, altered sensorium,drowsy, neck stiffness, headache, visual disturbance

26. Birth history

29. Comparison of patient’s weight before and after onset of illness

30. Concious level- GCS

31. Hydration status

32. Sunken frontanelle

33. Eyes sunken and tearless

34. Dry mucous membrane

35. Prolonged capillary refill time

36. Reduced skin turgor

38. Respiratory Examination Ear examination by otoscopy Fundoscopy

40. Plain Abdominal Xray

41. Barium mean

42. Barium follow through

43. Cranial CT

46. Asses the severity of dehydration Rehydrate accordingly Correct electrolyte imbalances Encourage oral intake Treat according to the underlying cause Management

47. References Nelson Text book of Peadiatrics 17th edition Hand book of Hospital peadiatrics 2nd edition Illustrated text book of paediatrics 3rd edition

48. Thank You