Diferencia entre revisiones de «Viral gastroenteritis»
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''See [[Acute gastroenteritis (peds)]] for pediatric patients'' | <languages/> | ||
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''See [[Special:MyLanguage/Acute gastroenteritis (peds)|Acute gastroenteritis (peds)]] for pediatric patients'' | |||
==Background== | ==Background== | ||
*Most common cause of [[acute gastroenteritis]] (AGE) | |||
*Most common cause of [[Special:MyLanguage/acute gastroenteritis|acute gastroenteritis]] (AGE) | |||
*Viral gastroenteritis usually lasts <7d | *Viral gastroenteritis usually lasts <7d | ||
*Do NOT diagnosis isolated vomiting as AGE! | *Do NOT diagnosis isolated vomiting as AGE! | ||
==Clinical Features== | ==Clinical Features== | ||
*[[Vomiting]] | |||
*Watery, non-bloody [[diarrhea]] | *[[Special:MyLanguage/Vomiting|Vomiting]] | ||
*Crampy/diffuse [[abdominal pain]] | *Watery, non-bloody [[Special:MyLanguage/diarrhea|diarrhea]] | ||
*Crampy/diffuse [[Special:MyLanguage/abdominal pain|abdominal pain]] | |||
*Features that suggest non-viral etiology: | *Features that suggest non-viral etiology: | ||
**[[rectal bleeding|Bloody diarrhea]] ([[Salmonella]], [[shigella]]) | **[[Special:MyLanguage/rectal bleeding|Bloody diarrhea]] ([[Special:MyLanguage/Salmonella|Salmonella]], [[Special:MyLanguage/shigella|shigella]]) | ||
**[[RLQ pain]] ([[Yersinia]], [[Entamoeba]]) | **[[Special:MyLanguage/RLQ pain|RLQ pain]] ([[Special:MyLanguage/Yersinia|Yersinia]], [[Special:MyLanguage/Entamoeba|Entamoeba]]) | ||
**Recent [[antibiotics]] + copious, foul diarrhea ([[C. Diff]]) | **Recent [[Special:MyLanguage/antibiotics|antibiotics]] + copious, foul diarrhea ([[Special:MyLanguage/C. Diff|C. Diff]]) | ||
**Consumption of previously cooked/reheated foods (especially meats, mayonnaise, etc.) | **Consumption of previously cooked/reheated foods (especially meats, mayonnaise, etc.) | ||
**Explosive, "rice-water" diarrhea ([[cholera]]) | **Explosive, "rice-water" diarrhea ([[Special:MyLanguage/cholera|cholera]]) | ||
**bloating, really nasty flatus/stools ([[giardia]]) | **bloating, really nasty flatus/stools ([[Special:MyLanguage/giardia|giardia]]) | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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{{Abdominal Pain DDX Diffuse}} | {{Abdominal Pain DDX Diffuse}} | ||
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{{Nausea and vomiting DDX}} | {{Nausea and vomiting DDX}} | ||
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==Evaluation== | ==Evaluation== | ||
*Assess hydration status | *Assess hydration status | ||
**Cap refill, skin turgor, respiratory rate | **Cap refill, skin turgor, respiratory rate | ||
*Consider stool studies if: | *Consider stool studies if: | ||
**>10 stools in previous 24hr | **>10 stools in previous 24hr | ||
**[[Traveler's diarrhea|Travel to high-risk country]] | **[[Special:MyLanguage/Traveler's diarrhea|Travel to high-risk country]] | ||
**[[Fever]] | **[[Special:MyLanguage/Fever|Fever]] | ||
**[[rectal bleeding|Bloody stool]] | **[[Special:MyLanguage/rectal bleeding|Bloody stool]] | ||
**Persistent diarrhea | **Persistent diarrhea | ||
==Management== | ==Management== | ||
#Rehydration (PO preferred) | #Rehydration (PO preferred) | ||
#*30mL(1oz)/kg/hr | #*30mL(1oz)/kg/hr | ||
#*[[Reduced-osmolarity oral rehydration solution]] | #*[[Special:MyLanguage/Reduced-osmolarity oral rehydration solution|Reduced-osmolarity oral rehydration solution]] | ||
#[[Antiemetics]] | #[[Special:MyLanguage/Antiemetics|Antiemetics]] | ||
#*[[Ondansetron]] 0.15mg/kg/dose IV/PO | #*[[Special:MyLanguage/Ondansetron|Ondansetron]] 0.15mg/kg/dose IV/PO | ||
#*May worsen diarrhea | #*May worsen diarrhea | ||
==Disposition== | ==Disposition== | ||
*Most can be discharged | *Most can be discharged | ||
===Admit=== | ===Admit=== | ||
*Unable to tolerate PO | *Unable to tolerate PO | ||
*Hemodynamic instability | *Hemodynamic instability | ||
*Significant comorbidities | *Significant comorbidities | ||
==See Also== | ==See Also== | ||
*[[Acute gastroenteritis]] | |||
*[[Nausea and Vomiting]] | *[[Special:MyLanguage/Acute gastroenteritis|Acute gastroenteritis]] | ||
*[[Acute gastroenteritis (peds)]] | *[[Special:MyLanguage/Nausea and Vomiting|Nausea and Vomiting]] | ||
*[[Dehydration]] | *[[Special:MyLanguage/Acute gastroenteritis (peds)|Acute gastroenteritis (peds)]] | ||
*[[Acute diarrhea]] | *[[Special:MyLanguage/Dehydration|Dehydration]] | ||
*[[Special:MyLanguage/Acute diarrhea|Acute diarrhea]] | |||
==External Links== | ==External Links== | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:ID]] [[Category:GI]] | [[Category:ID]] [[Category:GI]] | ||
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Revisión actual - 00:03 5 ene 2026
See Acute gastroenteritis (peds) for pediatric patients
Background
- Most common cause of acute gastroenteritis (AGE)
- Viral gastroenteritis usually lasts <7d
- Do NOT diagnosis isolated vomiting as AGE!
Clinical Features
- Vomiting
- Watery, non-bloody diarrhea
- Crampy/diffuse abdominal pain
- Features that suggest non-viral etiology:
- Bloody diarrhea (Salmonella, shigella)
- RLQ pain (Yersinia, Entamoeba)
- Recent antibiotics + copious, foul diarrhea (C. Diff)
- Consumption of previously cooked/reheated foods (especially meats, mayonnaise, etc.)
- Explosive, "rice-water" diarrhea (cholera)
- bloating, really nasty flatus/stools (giardia)
Differential Diagnosis
Diffuse Abdominal pain
- Abdominal aortic aneurysm
- Acute gastroenteritis
- Aortoenteric fisulta
- Appendicitis (early)
- Bowel obstruction
- Bowel perforation
- Diabetic ketoacidosis
- Gastroparesis
- Hernia
- Hypercalcemia
- Inflammatory bowel disease
- Mesenteric ischemia
- Pancreatitis
- Peritonitis
- Sickle cell crisis
- Spontaneous bacterial peritonitis
- Volvulus
Nausea and vomiting
Critical
Emergent
- Acute radiation syndrome
- Acute gastric dilation
- Adrenal insufficiency
- Appendicitis
- Bowel obstruction/ileus
- Carbon monoxide poisoning
- Cholecystitis
- CNS tumor
- Electrolyte abnormalities
- Elevated ICP
- Gastric outlet obstruction, gastric volvulus
- Hyperemesis gravidarum
- Medication related
- Pancreatitis
- Peritonitis
- Ruptured viscus
- Testicular torsion/ovarian torsion
Nonemergent
- Acute gastroenteritis
- Biliary colic
- Cannabinoid hyperemesis syndrome
- Chemotherapy
- Cyclic vomiting syndrome
- ETOH
- Gastritis
- Gastroenteritis
- Gastroparesis
- Hepatitis
- Labyrinthitis
- Migraine
- Medication related
- Motion sickness
- Narcotic withdrawal
- Thyroid
- Pregnancy
- Peptic ulcer disease
- Renal colic
- UTI
Evaluation
- Assess hydration status
- Cap refill, skin turgor, respiratory rate
- Consider stool studies if:
- >10 stools in previous 24hr
- Travel to high-risk country
- Fever
- Bloody stool
- Persistent diarrhea
Management
- Rehydration (PO preferred)
- 30mL(1oz)/kg/hr
- Reduced-osmolarity oral rehydration solution
- Antiemetics
- Ondansetron 0.15mg/kg/dose IV/PO
- May worsen diarrhea
Disposition
- Most can be discharged
Admit
- Unable to tolerate PO
- Hemodynamic instability
- Significant comorbidities