Upper or lower tract abnormalities can cause vomiting with possible etiologies including malrotation with or without volvulus, atresia of the antropyloric region, annular pancreas, atresia/stenosis of the small bowel or colon, functional obstructions caused by Hirschsprung disease, functional immaturity of the colon, and meconium ileus. Importantly, although malrotation most commonly presents in newborns, it can present at any time during life with decreasing frequency with age. Several GI pathologies to consider in a vomiting infant outside of the newborn period include hypertrophic pyloric stenosis (HPS), pylorospasm, formula intolerance, and gastroenteritis. In a young infant, less common GI etiologies include neonatal appendicitis, intussusception, gastric ulcer disease, gastric volvulus, trauma, and foreign body including lactobezoar. Medical causes to consider include sepsis, enteritis, pneumonia, otitis media, meningitis, raised trauma, or hydrocephalus), kernicterus, metabolic disorders (phenylketonuria, hyperammonemia, maple syrup urine disease, galactosemia, diabetes, adrenocortical hyperplasia, and methylmalonic acidemia), diencephalic syndrome, and rarely drugs or toxic agents [3-5]. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Vomiting in Infants Intussusception, which is unusual in the first 3 months of life, may be diagnosed clinically by crampy, intermittent abdominal pain sometimes progressing to bloody stools and lethargy. Patients with increased intracranial pressure may have an enlarging head circumference, bulging fontanelle, and/or neurologic signs [3,5].
Vomiting in Infants. Upper or lower tract abnormalities can cause vomiting with possible etiologies including malrotation with or without volvulus, atresia of the antropyloric region, annular pancreas, atresia/stenosis of the small bowel or colon, functional obstructions caused by Hirschsprung disease, functional immaturity of the colon, and meconium ileus. Importantly, although malrotation most commonly presents in newborns, it can present at any time during life with decreasing frequency with age. Several GI pathologies to consider in a vomiting infant outside of the newborn period include hypertrophic pyloric stenosis (HPS), pylorospasm, formula intolerance, and gastroenteritis. In a young infant, less common GI etiologies include neonatal appendicitis, intussusception, gastric ulcer disease, gastric volvulus, trauma, and foreign body including lactobezoar. Medical causes to consider include sepsis, enteritis, pneumonia, otitis media, meningitis, raised trauma, or hydrocephalus), kernicterus, metabolic disorders (phenylketonuria, hyperammonemia, maple syrup urine disease, galactosemia, diabetes, adrenocortical hyperplasia, and methylmalonic acidemia), diencephalic syndrome, and rarely drugs or toxic agents [3-5]. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Vomiting in Infants Intussusception, which is unusual in the first 3 months of life, may be diagnosed clinically by crampy, intermittent abdominal pain sometimes progressing to bloody stools and lethargy. Patients with increased intracranial pressure may have an enlarging head circumference, bulging fontanelle, and/or neurologic signs [3,5].