Vomiting common in childhood

Introduction to vomiting common in childhood Vomiting, which is common in childhood, is one of the common clinical symptoms in infants and children. Almost any infection or emotional stress can cause vomiting. Among them, the most common in the digestive system, central nervous system and urinary system diseases. Common causes are gastrointestinal infections, intestinal parasitic diseases, abdominal surgical diseases, various poisoning and drug reactions, acute metabolic disorders, central nervous system infections, increased intracranial pressure, cardiac insufficiency, etc., the primary cause is often due to age. different. basic knowledge The proportion of illness: 1.5% Susceptible people: infants and young children Mode of infection: non-infectious Complications: aspiration pneumonia

Common causes of vomiting in childhood

Common causes are gastrointestinal infections, intestinal parasitic diseases, abdominal surgical diseases, various poisoning and drug reactions, acute metabolic disorders, central nervous system infections, increased intracranial pressure, cardiac insufficiency, etc., the primary cause is often due to age. different.

Vomiting is a response to afferent stimuli mediated by the vomiting center located in the medulla oblongata. This afferent stimulus includes obstruction, or infection, from organs such as the throat, intestine, pleura, heart, genitourinary system, and hepatobiliary system. Balancer, metabolism (such as water and electricity balance) factors, azotemia and some drugs can stimulate the vomiting center, before vomiting, pyloric closure, gastric motility stop, pyloric and duodenal contraction, fundus filling, esophagus and Responsibility to relax, followed by gastrointestinal sinus, due to abdominal muscles, diaphragm muscle contraction, abdominal pressure is rapidly increased, while respiratory muscle contraction assists movement, so that stomach contents quickly pass through the cardia, esophagus and oral discharge, repeated Vomiting often causes the following changes:

1 vomiting loss of water and electrolytes affect the amount of liquid, easy to lead to dehydration;

2 gastric juice is rich in hydrochloric acid, infants and children with pyloric obstruction and vomiting children lose too much hydrochloric acid, easily lead to alkalosis, manifested as shallow breathing, slow or pause, increased excitability in children, decreased serum free calcium during alkalosis It can cause hand and foot convulsions and convulsions. At this time, blood chloride is reduced, hydrogen ion refers to (pH), urine chloride is reduced, and it is alkaline;

3 In infantile gastroenteritis and lower gastrointestinal obstruction, in addition to stomach acid also lost a large amount of intestinal alkaline fluid, such as repeated vomiting for a long time, so that children with long-term starvation, can lead to acidosis, manifested as listlessness, breathing Deep, serum sodium, chlorine decreased, hydrogen ion index decreased;

4 repeated vomiting, eating less, can lead to hypokalemia, urinary K + decreased and increased H +, and increased alkali poisoning, at this time the urine is acidic;

5 disease affects nutrient intake for a long time, can lead to malnutrition.

Common vomiting prevention in childhood

1. Regular diet, food should be fresh, clean, do not eat spicy, grilled and fatty food.

2. Breastfeeding should not be too hasty to prevent swallowing of air. After breastfeeding, you can hold the back of your child and pat the back so that the inhaled air can be discharged.

3. Those with mild vomiting can eat easily digestible liquid food, eat less meals, and vomiting is heavier, temporarily fasting.

4. When vomiting, the child should be placed on the side to prevent vomiting into the trachea.

5. When the drug is administered, do not use too much heat. Take the medicine should be slow. Use a small amount of multiple times. If necessary, take one bite, stop it, and take it again.

Common vomiting complications in childhood Complications, aspiration pneumonia

Reflux esophagitis, aspiration pneumonia, respiratory infection, refractory asthma, asphyxia or apnea in premature infants, sudden infant death syndrome, malnutrition, repeated oral ulcers, sinusitis, neuropsychiatric symptoms, Sandifer syndrome and baby crying Noisy syndrome, etc.

Common vomiting symptoms in childhood common symptoms diarrhea nausea pyloric stenosis

1, the type of vomit can be divided into 3 types:

1 galactorrhea: In small babies, the stomach is level, the stomach muscles are not perfect, and the cardia is slack. Therefore, when breastfeeding is excessive or when air is swallowed, a small amount of milk is often spilled from the mouth after eating, which does not affect health;

2 ordinary vomiting: often nausea before vomiting, after a spit or even a few mouthfuls, even spit or repeated vomiting are pathological, more common in gastrointestinal infections;

3 jet vomiting: more nausea before vomiting, a large number of stomach contents suddenly sprayed through the mouth or at the same time from the nostrils, can be seen in small infants swallowing a lot of air, stomach twist, pyloric obstruction and increased intracranial pressure.

2, vomiting time and vomit properties

The time of vomiting and the nature of vomit are related to the diagnosis. Please pay attention to the medical history. For example, upper gastrointestinal obstruction and food poisoning often cause vomiting in the early stage of the disease; lower gastrointestinal obstruction and renal failure are in the later stage. When vomiting occurs, congenital hypertrophic pyloric stenosis and gastric torsion, vomiting soon after feeding; ulcer disease complicated with part of pyloric obstruction, often vomiting 6 to 12 hours after a meal, hypertrophic pyloric stenosis only spit milk, do not vomit bile, When the obstruction is below the duodenum, the bile is vomited; in the late stage of the lower gastrointestinal obstruction, the vomit may have feces; after the hemorrhagic disease or nasal discharge, the vomit may carry blood; repeated vomiting and vomiting may bring blood or coffee slag. Things, when spit out the stomach content, more sour; when the food in the stomach is slippery, the spit may have a sour taste; when there is feces, there may be a fecal smell.

Common vomiting examination in childhood

Physical examination: For every vomiting newborn, a comprehensive physical examination should be performed to observe signs of systemic infection, signs of nervous system diseases and signs of metabolic diseases, with emphasis on abdominal and nervous system signs.

Auxiliary inspection:

(1) Nasogastric examination

It is a simple and effective method to check the upper gastrointestinal malformation. When the mother has too much amniotic fluid, or the baby has a mouth-like crab-like foam in the short term after birth, the nasogastric tube should be in the lower part of the delivery room. Smoothly enter the stomach and take a small amount of fluid, such as the lowering of the nasogastric tube or returning from the mouth or nasal cavity to indicate esophageal atresia

(2) X-ray examination

1 abdominal perspective and film

Abdominal fluoroscopy and radiography are the most commonly used diagnostic methods for neonatal vomiting. In order to better observe the flatulence and fluid level of flatulence, vertical fluoroscopy and radiography should be used, as well as lateral lateral projection.

2 barium or barium enema examination

It can observe the shape and function of esophagus and intestines, and has important value for the diagnosis of moral deterioration of digestive tract diseases. Forbidden sputum angiography in neonates with complete gastrointestinal obstruction or perforation, suspected esophageal atresia or esophageal tracheal fistula The blood iodine agent can be used for angiography, and the contrast agent is aspirated in time after the angiography.

3 ultrasound examination

Ultrasound examination of ascites: diagnosis of the location and nature of abdominal mass, presence of free gas in the abdominal cavity, etc., with high sensitivity and specificity for choledochal cyst, adrenal hyperplasia, neonatal necrotizing small intestine The diagnosis of diseases such as inflammation is superior to X-ray examination. Ultrasound examination of hypertrophic pyloric stenosis has basically replaced barium meal examination. Ultrasound examination can not only observe some changes in the gastrointestinal tract but also directly observe the hepatobiliary system, urinary system. Changes in the circulatory system and its effects on the digestive tract are helpful in the diagnosis of the cause of vomiting.

4 gastroscope

Newborns often need less clinical application under general anesthesia. Gastroscopic examination can directly observe mucosal congestion, hemorrhage, ulcers, scar tumors and congenital malformations. It has a diagnostic significance for certain esophageal and gastric diseases.

Diagnosis of common vomiting diagnosis in childhood

It can be diagnosed based on medical history, clinical symptoms and laboratory tests.

Need to identify galactorrhea, inconsistent swallowing action, swallowing syndrome, infection with neonatal hepatitis, neonatal necrotizing enterocolitis, gastroesophageal reflux, achalasia, pyloric fistula, meconium constipation, neonatal constipation, cranial Increased internal pressure, inherited metabolic disease, allergic disease, esophageal atresia and esophageal tracheal fistula, hernia, hiatal hernia, hypertrophic pyloric stenosis, pyloric anterior septum, gastric torsion congenital intestinal atresia, intestinal stenosis, intestinal malrotation, fetal Fecal peritonitis, congenital megacolon, anal and rectal malformations.

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