1/21/2021
Official reprint from UpToDate®
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Common or critical causes of vomiting in the pediatric age range
Neonate
Physiologic reflux or
GERD*
Dietary protein
intolerance* or
allergy (eg, milk protein-
induced enteritis)  GERD*
Pyloric stenosis
Necrotizing enterocolitis
Malrotation with midgut
volvulus
Congenital atresias,
stenoses, webs 
Gastroenteritis
Hirschsprung disease
Inborn errors of
metabolism (eg, organic
acidemias, urea cycle
disorders, galactosemia,
hereditary fructose
intolerance)
Feeding intolerance
(may be associated with
cardiac, pulmonary,
renal, or neuromotor
disorders)
Adrenal crisis
Hepatobiliary disease
Medical child abuse  Obstruction (eg,
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Dx vomiting children by age - UpToDate
Infancy Childhood Adolescence
Physiologic reflux or Gastroenteritis* Gastroenteritis*
GERD*
Streptococcal Posttussive* (asthma,
Gastroenteritis* pharyngitis*  infection, foreign body)
Dietary protein Posttussive* Functional dyspepsia* 
intolerance* or (asthma, infection,
 
allergy (eg, milk protein- foreign body) 
induced enteritis) Streptococcal pharyngitis 
Functional
Obstruction (eg, dyspepsia* Pregnancy 
intussusception, Bulimia 
GERD* 
malrotation,
Drugs of abuse 
Hirschsprung disease, Peptic ulcer
pyloric stenosis) Suicide attempt 
Cyclic vomiting
Inborn errors of Psychogenic Peptic ulcer
metabolism (eg,
Increased Appendicitis
hereditary fructose
intracranial pressure Cannabis hyperemesis
intolerance,
(tumor, syndrome 
galactosemia, organic
hydrocephalus,
acidemias, urea cycle Psychogenic
subdural hematoma
disorders) 
from child abuse) Gastroparesis 
Infant rumination
Otitis media  Intracranial mass
Otitis media 
Urinary tract Cyclic vomiting
Urinary tract infection infection
Eosinophilic
Toxic ingestion Toxic ingestion gastroenteritis/esophagitis
Increased intracranial Diabetic Diabetic ketoacidosis 
pressure (subdural ketoacidosis  Obstruction (eg,
hematoma from child
Eosinophilic malrotation,
abuse, hydrocephalus)
esophagitis intussusception,
Hepatobiliary disease incarcerated hernia)
Renal disease malrotation, Hepatobiliary disease
(obstructive uropathy, intussusception, Renal disease (renal
renal insufficiency)  incarcerated hernia)
insufficiency)  
Pancreatitis Hepatobiliary Pancreatitis
Adrenal crisis  disease
Adolescent rumination
Medical child abuse  Renal disease (renal syndrome
insufficiency) 
Adrenal crisis 
Pancreatitis
Medical child abuse 
Gastroparesis
Adrenal crisis 
Medical child abuse 
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1/21/2021 Dx vomiting children by age - UpToDate

GERD: gastroesophageal reflux disease

*Common cause in this age group

Graphic 51919 Version 14.0

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