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Vomit versus spit up


Vomit versus spit up

المعلومة

هناك اختلاف بين الإقياء-vomit- و البصق- spit up- و الذي لا يتطلب حدوثه تقلص عضلي إنما يتم غالباً بسبب التجشؤ التالي للطعام.
البصاق شائع عند الرضع في الأشهر الأولى من العمر، وهو لا يدل بالضرورة على وجود مادة محسسة في الحليب الوالدي.
ولا يتطلب المعالجة مادام الرضيع يتغذى و ينمو بشكل جيد، إلا أنه يصبح مصدر قلق عندما يزداد معدل البصق عن المعتاد،يرفض الطفل أن يأكل، يبكي باستمرار مشيراً لتألمه، يتشردق خلال البصق، أو يتقيأ بشكل قذفي، أو يتوقف عن كسب الوزن وهنا يتطلب ذلك مراجعة الطبيب.

المرجع

lina's picture
by
السنة السادسة

Quote:
أو يتقيأ بشكل قذفي،

منت صفات الاقياء بتضيق البواب الضخامي الذي يتظاهر غالبا بالاسابيع 2-3 من الحياة
شكرا

qusei


i lyk gastroenterology , i will talk alot , forgive me


a golden rule:

starting with red flags is very nice approach to know weither its a pt u will run with in ER or sit and chat till u solve the puzzle

if a mother came to me saying my baby vomited

the first thing i would do is flex his neck .. exclude meningitis

search for signs of raised ICP .. exlude brain tumors , intracranial hemorrhage

ask if he's diabetic, check his glucose ... exclude DKA

ask if its a red jelly stool and search for signs of intussusception
many ppl will disagree but i will go directly for deep palpatation and search for sausage mass in the rt upper quadrant

if not

i will sit , and start clarifying


1: wat do u mean ?

is it forceful , with forceful abdominal contraction ( vomiting ) ,
or is it nonforceful with no ab contraction ( regurgitation )
or is it only small amounts of milk accompanying return of swallowed air ( posseting )

--------

2nd , clues to vomiting :

projectile - not bile stained --- think pyloric stenosis from which u can zoom into wt loss , onset after meals etc ..
bile stained --- exclude other types of intestinal obstruction--
with transient sympotms lyk fever / diarrhea or cough ---URTI / GE most likely
is there hematemesis with the vomiting ? --maybe its hiatus hernia
did the baby pass meconium ? --- maybe imperforate anus
---------

3rd , if its regurgitation :

pls describe for me how do u feed your baby ?
is it a feeding error ? -- overfeeding ?excess handling after feeding ?

if the baby sits upright for a while after feeding does it prevent regurge ? ---think of GERD--zoom into aspiration , wheezez etc..

does the baby cry excesssively on feeding due to heartburn ? -- maybe GERD complicated with esophagitis

( many pts say min zaman and doctors skip , 6ayyeb min mata hal min zaman , maybe we're dealing with an acute on top of chronic , maybe a complication of an undiagnosed disease)

is there excess saliva , choking , cyanosis ? --- congenital esophageal atresia +- tracheoesophageal fistula

many other causes

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امرأة لا تتكرر's picture
امرأة لا تتكرر
السنة الخامسة


Having gastric contents reaching the stomach can be eaither
A- Forcefull = vomiting
B- Nonforcefull = Reflux or regurgitation
and if it reaches the mouth then get swallowed again by the patient = rumination

ABIM's picture
ABIM
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