Recurrent vomiting in children
Introduction
Introduction to recurrent vomiting in children Recurrentvomiting, also known as cyclicvomiting, is a form of refractory vomiting. Vomiting is a complex reflex action. The vomiting center is located in the medulla, adjacent to the vagus nucleus and the respiratory center. Vomiting is caused by a series of complex and coordinated neuromuscular activities. basic knowledge The proportion of illness: 0.001% Susceptible people: children Mode of infection: non-infectious Complications: dehydration, metabolic acidosis, hypokalemia
Cause
Causes of recurrent vomiting in children
Causes:
Repeated episodes of vomiting often last for several years, may have a family history, brothers and sisters have the same disease, may be related to physical factors, overeating, excessive fat, constipation, upper respiratory tract infection, hunger, strenuous physical activity, fatigue Or mental stimulation is a common cause, especially pre-adolescent girls, often due to anxiety or mood swings.
Prevention
Recurrent vomiting prevention in children
Prevent overeating greasy food, prevent vomiting, prevent upper respiratory tract infection, hunger, constipation, etc., and prevent excessive fatigue, vigorous physical activity, and prevent anxiety and mood swings.
Complication
Complications of recurrent vomiting in children Complications, dehydration, metabolic acidosis, hypokalemia
Often complicated by dehydration, acidosis, ketoacidosis, hypokalemia and so on.
Symptom
Symptoms of recurrent vomiting in children Common symptoms Frail hypokalemia abdominal pain drowsiness dehydration
Repeated vomiting, vomiting several times a day to dozens of times, about 1 to 5 days, can be extended to 1 week, then naturally healed, can be attacked several times within 1 year, no discomfort during the interictal period, vomiting is very intense, feeding Or the drinking water is all spit out, the spit sometimes contains blood or bile. In severe cases, it spits a lot of coffee-like substances, often accompanied by thirst, headache or abdominal pain. The vomiting will quickly lead to weakness in the whole body, mental wilting, and some sleepiness after vomiting. Vomiting, can not eat easily lead to dehydration and acid-base balance disorder, children with blood, urinary ketone body increased, blood glucose decreased, blood chlorine decreased, vomiting is prone to hypokalemia.
Examine
Examination of recurrent vomiting in children
Repeated vomiting can cause water and electrolyte disorders, according to the condition of serum sodium, chlorine, potassium, blood pH, urea nitrogen, blood sugar, urine ketone body, etc.; suspected cranial brain disease when necessary to do cerebrospinal fluid routine examination, if necessary, do vomit test , poison analysis and other checks.
Abdominal X-ray or plain film, gastrointestinal barium meal or photo, endoscopy, etc., help to understand digestive tract obstruction, abdominal inflammation or congenital gastrointestinal malformation, suspected intracranial hemorrhage, intracranial space-occupying lesions It can be used for brain ultrasound, cerebral angiography, computed tomography and magnetic resonance imaging.
Diagnosis
Diagnosis and diagnosis of recurrent vomiting in children
There are often family history and recurrent episodes, often accompanied by blood, elevated ketone bodies in the urine, and can be diagnosed except for other causes.
Should pay attention to the age of onset and physical factors, vomiting is easy to be confused with organic diseases of the central nervous system such as meningitis, brain tumors, and acute abdomen, but the nervous system and abdominal examination and barium meal examination are normal, EEG Examination sometimes shows the epileptic waveform, but it is ineffective with anti-epileptic drugs. Later, as the age increases, the onset of puberty becomes lighter, the number of times decreases and gradually heals. Individual children have migraine after puberty.
Differential diagnosis must be associated with increased intracranial pressure (intracranial infections and tumors), congenital metabolic diseases such as phenylketonuria, galactosemia, and urea cycle disease. Repeated vomiting may also occur. In children with recurrent vomiting and varying degrees of disturbance of consciousness, autonomic epilepsy must be considered.
