🚫 Approach to Neonatal vomiting
⚛ When you have patient with vomiting you have to be sure if its real vomiting ?
What is the type of this vomiting ?
Does the patient active , alert , or sick and ill ?
Not bile stain ?
Tolerate feeding ?
No hx of constipation ?
No abdominal distension
No blood in vomitus
لذلك ال General look مهم
🚫 If well , active , no abdominal distension , no constipation , no bile or blood in vomitus ➡️ Benign causes
✔ overfeeding لذلك نسألها كم مرة ترضعه
✔ GERD ➡️ usually in late neonatal period and its effortless
✔ Swallowing of maternal blood and secretion ➡️ Gastritis ➡️ Rx ⚛ Gastric wash with Ns ندفع 5 cc ونسحبها لحد ما يصير clear
✔ Food or milk allergy
✔ Hypertrophic pyloric stenosis ( baby earlier is healthy ) .
🚫 If ill patient
⚛ Medical causes ➡️
✔ Infection ➡️ sepsis , meningitis
✔ Raised intracranial pressure
✔ Inborn error of metabolism
⚛ Surgical causes
✔ Esophageal atresia ➡️ large amount of frothy secretion , scaphoid abdomen cuz there is no Air .
If with SOB ➡️ Fistula
✔ Doudenal atresia ➡️ On x ray double bubble sign
..........
🚫 Upper GIT obstruction
✔ earlier vomiting
✔ less abdominal diatension
🚫 Lower Git obstruction
✔ vomiting late
✔ remarkable abdominal distension
✔ multiple air fluid level on X ray
