Diferencia entre revisiones de «Nausea and vomiting»

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{{Adult top}}
<translate> [[Special:MyLanguage/nausea and vomiting (peds)|nausea and vomiting (peds)]]. For nausea and vomiting during pregnancy, see [[Special:MyLanguage/hyperemesis gravidarum|hyperemesis gravidarum]].''
==Background==
==Background==
[[File:Nausea_and_vomiting.png|thumb|Nausea and Vomiting Algorithm]]
[[File:Nausea_and_vomiting.png|thumb|Nausea and Vomiting Algorithm]]
==Work-Up==
#CBC
#Chemistry
#Urine pregnancy
#LFTs
#Lipase
#APAP, ASA, digoxin levels
#UA
#?Abd xray
#?CT
#?US


== DDX by organ system ==
===GI===
#[[Peptic ulcer disease]]
#Obstruction
##Adhesion
##[[Small bowel obstruction]]/LBO
##Gastric outlet obstruction
#[[Pancreatitis]]
#Gastroparesis
#[[Appendicitis]]
#[[Cholecystitis]]
#[[Cholangitis]]
#[[Acute Hepatitis]]
#IBD
#[[Intussusception]]
#Tumor
#Strangulated hernia
#[[Volvulus]]
#[[Mesenteric ischemia]]
#Esophageal disorders (e.g. achalasia)
#Functional disorders
##Psychogenic
##[[IBS]]
#[[Pyloric Stenosis]]


===Neurologic===
==Clinical Features==
#Head injury
 
#[[CVA]]
*Nausea and/or vomiting
#Pseudotumor
*Additional features of underlying process
#Hydrocephalus
 
#Mass lesion
 
#[[Meningitis]]
==Differential Diagnosis==
#Migraines
 
#[[Labyrinthitis]]
</translate>
#Meniere disease
{{Nausea and vomiting DDX}}
#Motion sickness
<translate>
#[[Cannabinoid hyperemesis syndrome]]
 
 
===By organ system===
 
 
====GI====
 
*[[Special:MyLanguage/Peptic ulcer disease|Peptic ulcer disease]]
*[[Special:MyLanguage/Bowel obstruction|Obstruction]]
**Adhesion
**[[Special:MyLanguage/Small bowel obstruction|Small bowel obstruction]]/LBO
***[[Special:MyLanguage/SMA syndrome|SMA syndrome]]
**Gastric outlet obstruction
**[[Special:MyLanguage/Gastric volvulus|Gastric volvulus]]
**[[Special:MyLanguage/Bezoar|Bezoar]]
*[[Special:MyLanguage/Pancreatitis|Pancreatitis]]
*[[Special:MyLanguage/Gastroparesis|Gastroparesis]]
*[[Special:MyLanguage/Appendicitis|Appendicitis]]
*[[Special:MyLanguage/Cholecystitis|Cholecystitis]]
*[[Special:MyLanguage/Cholangitis|Cholangitis]]
*[[Special:MyLanguage/Acute Hepatitis|Acute Hepatitis]]
*[[Special:MyLanguage/IBD|IBD]]
*[[Special:MyLanguage/Intussusception|Intussusception]]
*Tumor
*Strangulated [[Special:MyLanguage/hernia|hernia]]
*[[Special:MyLanguage/Volvulus|Volvulus]]
*[[Special:MyLanguage/Mesenteric ischemia|Mesenteric ischemia]]
*Esophageal disorders (e.g. [[Special:MyLanguage/achalasia|achalasia]])
*Functional disorders
**Psychogenic
**[[Special:MyLanguage/IBS|IBS]]
*[[Special:MyLanguage/Pyloric Stenosis|Pyloric Stenosis]]
 
 
====Neurologic====
 
*[[Special:MyLanguage/Head injury|Head injury]]
*[[Special:MyLanguage/CVA|CVA]]
*[[Special:MyLanguage/Idiopathic intracranial hypertension|Idiopathic intracranial hypertension]]
*[[Special:MyLanguage/Hydrocephalus|Hydrocephalus]]
*[[Special:MyLanguage/Intracranial mass|Mass lesion]]
*[[Special:MyLanguage/Meningitis|Meningitis]]
*[[Special:MyLanguage/Migraine|Migraine]]
*[[Special:MyLanguage/Labyrinthitis|Labyrinthitis]]
*[[Special:MyLanguage/Meniere's disease|Meniere's disease]]
*[[Special:MyLanguage/Motion sickness|Motion sickness]]
*[[Special:MyLanguage/Cannabinoid hyperemesis syndrome|Cannabinoid hyperemesis syndrome]]
 
 
====Infectious====
 
*[[Special:MyLanguage/Bacteria|Bacteria]]l toxins
*[[Special:MyLanguage/Pneumonia|Pneumonia]]
*[[Special:MyLanguage/SBP|SBP]]
*[[Special:MyLanguage/UTI|UTI]]
*Viruses ([[Special:MyLanguage/adenovirus|adenovirus]], [[Special:MyLanguage/norovirus|norovirus]], [[Special:MyLanguage/rotavirus|rotavirus]])
 
 
====Drugs/Toxins====
 
*Toxic doses
**[[Special:MyLanguage/Digoxin toxicity|Digoxin toxicity]]
**[[Special:MyLanguage/Aspirin toxicity|Aspirin toxicity]]
**[[Special:MyLanguage/Acetaminophen toxicity|Acetaminophen toxicity]]
**[[Special:MyLanguage/Ipecac toxicity|Ipecac toxicity]]
*[[Special:MyLanguage/NSAIDs|NSAIDs]]
*[[Special:MyLanguage/Opioids|Opioids]]
*[[Special:MyLanguage/Alcohol|Alcohol]]
*[[Special:MyLanguage/Anticonvulsants|Anticonvulsants]]
*[[Special:MyLanguage/Antibiotics|Antibiotics]]
*[[Special:MyLanguage/Antiarrhythmics|Antiarrhythmics]]
*Toxins
**[[Special:MyLanguage/Organophosphates|Organophosphates]]
**[[Special:MyLanguage/Carbon monoxide|Carbon monoxide]]
**[[Special:MyLanguage/Ricin|Ricin]]
*[[Special:MyLanguage/Acute radiation syndrome|Acute radiation syndrome]]
 
 
====Endocrine====
 
*[[Special:MyLanguage/Pregnancy|Pregnancy]], [[Special:MyLanguage/hyperemesis gravidarum|hyperemesis gravidarum]]
*[[Special:MyLanguage/Hyponatremia|Hyponatremia]]
*[[Special:MyLanguage/Adrenal insufficiency|Adrenal insufficiency]]
*[[Special:MyLanguage/DKA|DKA]]
*[[Special:MyLanguage/Thyroid|Thyroid]]/parathyroid disorders
*[[Special:MyLanguage/Uremia|Uremia]]
 
 
====Miscellaneous====
 
*[[Special:MyLanguage/ACS|ACS]]
*[[Special:MyLanguage/Ovarian torsion|ovarian]]/[[Special:MyLanguage/testicular torsion|testicular torsion]]
*[[Special:MyLanguage/Nephrolithiasis|Nephrolithiasis]]
*Pain
*[[Special:MyLanguage/Acute angle-closure glaucoma|Acute angle-closure glaucoma]]
*[[Special:MyLanguage/Anorexia nervosa|Anorexia nervosa]]/[[Special:MyLanguage/bulimia nervosa|bulimia nervosa]]
*[[Special:MyLanguage/Depression|Depression]]
 
 
==Evaluation==
 
''Varies widely depending on clinical presentation''
*CBC
*Chemistry
*Urine pregnancy
*[[Special:MyLanguage/LFTs|LFTs]]
*Lipase
*APAP, ASA, digoxin levels
*[[Special:MyLanguage/Urinalysis|Urinalysis]]
*?[[Special:MyLanguage/Abdominal xray|Abdominal xray]]
*?CT
*?[[Special:MyLanguage/Ultrasound|Ultrasound]]
 
 
==Management==
 
*Treat underlying pathology
*Address [[Special:MyLanguage/electrolyte derangements|electrolyte derangements]] and [[Special:MyLanguage/dehydration|dehydration]] as needed
*[[Special:MyLanguage/Antiemetics|Antiemetics]]
*Inhaled isopropyl alcohol (sniffing an alcohol wipe) has been shown to reduce mild to moderate nausea and vomiting<ref>Lindblad AJ, Ting R, Harris K. Inhaled isopropyl alcohol for nausea and vomiting in the emergency department. Can Fam Physician. 2018;64(8):580.</ref>
 
 
==Disposition==
 
*Depends on cause
*Most non-specific episodes of acute nausea and vomiting may be discharged, if:
**No emergent/urgent cause identified or suspected
**Patient tolerating fluids after treatment
 
 
==Complications==
 
*[[Special:MyLanguage/Hypovolemia|Hypovolemia]]
*[[Special:MyLanguage/Metabolic alkalosis|Metabolic alkalosis]]
*[[Special:MyLanguage/Hypokalemia|Hypokalemia]]
*[[Special:MyLanguage/Mallory-Weiss|Mallory-Weiss]] (tear)
*[[Special:MyLanguage/Boerhaave|Boerhaave]] (rupture)
*Aspiration


===Infectious===
#Bacterial toxins
#[[PNA]]
#[[SBP]]
#[[UTI]]
#Viruses (adeno, norwalk, rota
===Drugs/Toxins===
#Toxic doses
##Digoxin
##ASA
##APAP
#NSAIDs
#Opiates
#ETOH
#Anticonvulsants
#Abx
#Antiarrhythmics
#Toxins
##Organophosphates
##CO
##Ricin
===Endocrine===
#Pregnancy
#[[Hyponatremia]]
#Adrenal insufficiency
#[[DKA]]
#Thyroid/parathyroid disorders
#[[Uremia]]


===Miscellaneous===
==See Also==
#[[ACS]]
#Gonadal torsion
#[[Nephrolithiasis]]
#Pain
#Acute glaucoma
#Anorexia/bulimia
#Depression


==DDx by Severity==
*[[Special:MyLanguage/Nausea and vomiting (peds)|Nausea and vomiting (peds)]]
=== Critical ===
*[[Special:MyLanguage/Nausea and vomiting of pregnancy|Nausea and vomiting of pregnancy]]
#[[Esophageal Perforation|Boerhaave's]]
*[[Special:MyLanguage/Antiemetics|Antiemetics]]
#Ischemic bowel
#[[ICH]]
#[[Meningitis]]
#[[DKA]]
#[[AMI]]
#[[Sepsis]]


=== Emergent ===
#Gastric outlet obstruction
#[[Pancreatitis]]
#[[Cholecystitis]]
#Bowel obstruction/ileus
#Ruptured viscus
#[[Appendicitis]]
#Peritonitis
#Migraine
#CNS tumor
#raised ICP
#Adrenal insuffciency
#Hyperemesis gravidarum
#Tylenol
#Digoxin
#ASA
#Theophyline
#Gonadal torsion
#CO
#[[Electrolyte Disorders]]
===Nonemergent===
#[[Gastritis]]
#Gastroparesis
#PUD
#Gastroenteritis
#Biliary colic
#Hepatitis
#Thyroid
#Pregnancy
#Erythromycin
#Ibuprofen
#Chemotherapy
#Narcotics/wdwl from
#ETOH
#UTI
#Renal colic
#Motion sickness
#Labyrinthitis


== Complications ==
==External Links==
#Hypovolemia
#Metabolic alkalosis
#Hypokalemia
#Mallory-Weiss (tear)
#Boerhaave (rupture)
#Aspiration


== Peds ==


{| cellspacing="1" cellpadding="3" border="0" bgcolor="#666666" width="100%"
==References==
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" colspan="2" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | '''Newborn'''&nbsp;
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Obstructive intestinal anomalies
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Esophageal stenosis/atresia, pyloric stenosis, intestinal stenosis/atresia, malrotation ± volvulus, incarcerated hernia, meconium ileus/plug, Hirschsprung disease, imperforate anus, enteric duplications
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Neurologic
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Intracranial bleed/mass, hydrocephalus, cerebral edema, kernicterus
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Renal
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Urinary tract infection, obstructive uropathy, renal insufficiency
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Infectious
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Viral illness, gastroenteritis, meningitis, sepsis
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Metabolic/endocrine
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Inborn errors of metabolism (urea cycle, amino/organic acid, carbohydrate), congenital adrenal hyperplasia
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Miscellaneous
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Ileus, gastroesophageal reflux, necrotizing enterocolitis, milk allergy, GI perforation
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" colspan="2" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | '''Infant (<12 mo)'''&nbsp;
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Obstructive intestinal anomalies
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Pyloric stenosis, malrotation ± volvulus, incarcerated hernia, Hirschsprung disease, enteric duplications, intussusception, foreign body, bezoars, Meckel diverticulum
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Neurologic
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Intracranial bleed/mass, hydrocephalus, cerebral edema
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Renal
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Urinary tract infection, obstructive uropathy, renal insufficiency
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Infectious
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Viral illness, gastroenteritis, meningitis, sepsis, otitis media, pneumonia, pertussis, hepatitis
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Metabolic/endocrine
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Inborn errors of metabolism, adrenal insufficiency, renal tubular acidosis
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Miscellaneous
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Ileus, gastroesophageal reflux, post-tussive, peritonitis, drug overdose
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | '''Child (>12 mo)'''&nbsp;
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | &nbsp;
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Obstructive intestinal anomalies
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Malrotation ± volvulus, incarcerated hernia, Hirschsprung disease, intussusception, foreign body, bezoars, Meckel diverticulum, acquired esophageal stricture, peptic ulcer disease, adhesions, superior mesenteric artery syndrome
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Neurologic
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Intracranial bleed/mass, cerebral edema, postconcussive, migraine
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Renal
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Urinary tract infection, obstructive uropathy, renal insufficiency
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Infectious
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Viral illness, gastroenteritis, meningitis, sepsis, otitis media, pneumonia, hepatitis, streptococcal pharyngitis
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Metabolic/endocrine
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Inborn errors of metabolism, adrenal insufficiency, renal tubular acidosis, diabetes mellitus, Reye syndrome, porphyria
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; "
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Miscellaneous
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Ileus, gastroesophageal reflux, post-tussive, peritonitis, drug overdose, appendicitis, pancreatitis, gastritis, Crohn disease, pregnancy, psychogenic, cyclic vomiting syndrome
|}


== Source ==
<references/>
*Rosen
*Tintinalli


[[Category:GI]]
[[Category:GI]]
[[Category:Peds]]
[[Category:Symptoms]]
</translate>

Revisión actual - 23:47 4 ene 2026


This page is for adult patients. For pediatric patients, see: 

nausea and vomiting (peds). For nausea and vomiting during pregnancy, see hyperemesis gravidarum.

Background

Nausea and Vomiting Algorithm


Clinical Features

  • Nausea and/or vomiting
  • Additional features of underlying process


Differential Diagnosis

Nausea and vomiting

Critical

Emergent

Nonemergent


By organ system

GI


Neurologic


Infectious


Drugs/Toxins


Endocrine


Miscellaneous


Evaluation

Varies widely depending on clinical presentation


Management


Disposition

  • Depends on cause
  • Most non-specific episodes of acute nausea and vomiting may be discharged, if:
    • No emergent/urgent cause identified or suspected
    • Patient tolerating fluids after treatment


Complications


See Also


External Links

References

  1. ↑ Lindblad AJ, Ting R, Harris K. Inhaled isopropyl alcohol for nausea and vomiting in the emergency department. Can Fam Physician. 2018;64(8):580.
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