Vomiting in children

Vomiting in children is more common than in adults, and there comes the easier it is, the less a child. Causes of vomiting in children diverse. It is observed in many infectious diseases (usually vomiting appears at the beginning of the disease, "unmotivated"), the anomalies and diseases of the gastrointestinal tract, food poisoning, and diseases of other organs (liver, urinary tract and other). Some children vomiting may be neurogenic.
Vomiting in children have a different value in the diagnosis of the disease depending on age: the older children vomiting in nature is not very different from vomiting adults and in children of early age is often the main symptom of common diseases.
In children of the first months of life vomiting may take a peculiar form of vomiting, which occurs without prior nausea, voltage abdominals, poslednee person, etc. Mechanism regurgitation is to reduce stomach with an open cardia under the influence of local reflex. Regurgitation and vomiting can be a functional one. In the first hours of life in infants vomiting may occur as a result of swallowing amniotic fluid. Such vomiting stops without treatment; sometimes you have to delay the attachment at the breast. A simple regurgitation observed in promiscuous breastfeeding, usually when overfeeding; it is to a certain extent physiological and to 4-6 months. stops. The so-called usual vomiting occurs in children-aeroperu, proglatyvayushchiy together with the milk the air. Then the air, struggling with the strength of the stomach, carries and its contents. In children with temporary atony cardiac sphincter easy to get regurgitation when diapering, voltage abdomen (for example, when you cry) or change of position. Regurgitation and vomiting may occur when an incomplete development of the nervous system, gastrointestinal tract.
Diagnosis vomiting organic origin in newborns and children of the first months of life is critical, as persistent vomiting at this age is the leading symptom of a number of defects that cause the violation of patency of food through the digestive tract and requiring immediate surgery. These are: atresia of the esophagus, the pyloric stenosis, malformations of the duodenum, atresia thin or large intestine, some forms of diaphragmatic hernia. Non-permanent vomiting with simultaneous delay chair makes a partial intestinal obstruction, depending on the unfinished rotation in the embryonic period or from congenital stenosis of the digestive tube.
The differential diagnosis vomiting in infants remember meconium plug intestinal obstruction and peritonitis in cystic fibrosis (see). In children during the first weeks of life persistent vomiting can be a symptom of adrenogenital syndrome (see) with violation of the exchange of electrolytes.
The diagnosis can be refined on the basis of the nature of vomit. Vomiting nesterovska milk indicates the obstruction of the upper digestive tract (esophageal atresia, kardiospazm). The crud in vomitus points to delay him in the stomach (pilorospazm, pyloric stenosis). The admixture of bile vomit mass indicates obstacle in the duodenum, as well as anomalies of the development of intestines.
The sharp smell of vomit seen if fecal" vomiting if running intestinal obstruction, peritonitis. Bloody vomiting happens at Melun in newborns, vomiting "coffee grounds" (dark blood) - in infectious toxicosis; if both have black feces, you can suspect bleeding Meckel's diverticulum or doubling the intestinal tube with ulceration its walls. Children of any age may experience vomiting due to neuropathy. Aged 2-8 years is acetonemia vomiting (see acetone anaemia).
First aid. To prevent aspiration of vomitus, the child should be put on side, repelent it, remove constricting clothing. It is recommended to ventilate the room in which it is located. After vomiting child should rinse your mouth with cool water and some time is not. If the child is small and can not rinse your mouth, you can give him to drink some tea spoons cool boiled water.
Treatment vomiting depends on its origin. You must treat the underlying disease, such as gastritis (see), dyspepsia (see), food poisoning (see). Vomiting caused indiscriminate feeding, strict adherence to the diet. When neurogenic vomiting must follow a strict diet, unacceptable forced feeding. Should ensure a calm attitude to the child, at the same time, exaggerated care may contribute to fixing the attention of the child on the painful symptoms and hinder treatment. Children easily excitable, disturbed sleep when neurogenic vomiting are recommended or motherwort tincture of Valerian (2-5 drops 3 times a day), 0.5% solution of sodium bromide 3 times a day (children under 3 years of age - 1 tea spoon, more senior - 1 table spoon). Shows the use of glycerol calcium 0.05-0.2 g 2-3 times a day, multivitamins.
Conservative treatment is carried out only if there is no organic cause detectable by x-ray.
If dehydration caused by persistent vomiting, impose 5% glucose solution, ingerowski solution izotoniceski solution of sodium chloride. Children under the age of 1 year the total amount of liquid, introduced by mouth, intravenously, subcutaneously, enemas, should not exceed 150 - 180 ml per 1 kg of weight per day.
Older children will apply 10% solution of calcium chloride or sodium chloride to 10 ml in Vienna (enter slowly!). Subcutaneously injected 10% solution caffeine-benzoate sodium in a single dose of 0.2 to 1 ml depending on the age.
With repeated vomiting do intramuscular injection of 2.5% solution of chlorpromazine. Ampoules containing 1-2 ml of 2.5% solution of chlorpromazine, mix equal amount of 0.5% solution novokaina. When using a 2.5 % solution of chlorpromazine the number of input solution per 1 kg of weight per day will be: in the age of 1 month.- 0,04 ml, 2-12 months -0,06 ml 1-3 years -0,08-0,1 ml, 4-6 years - 0,12-0,15 ml, 6-7 years - 0,16 mg, 8 years and older - 0,18-0,2 ml, but not more than 4 ml per day.