Differential Diagnosis for Primi 2 months with Vomitings 4-5 times, 3 days
- Single most likely diagnosis:
- Gastroesophageal reflux disease (GERD): This is a common condition in infants, characterized by the backflow of stomach contents into the esophagus, leading to vomiting. The symptoms presented, such as frequent vomiting in a 2-month-old primipara (first-time mother), could align with GERD, especially given its prevalence in this age group.
- Other Likely diagnoses:
- Viral gastroenteritis: This is a common cause of vomiting in infants, often accompanied by diarrhea. The fact that the vomiting has persisted for 3 days could suggest a viral etiology.
- Overfeeding or feeding intolerance: Infants, especially those who are bottle-fed, might experience vomiting due to overfeeding or an intolerance to a component of their formula.
- Pyloric stenosis: Although less common, this condition, which involves a narrowing of the pylorus (the passage linking the stomach to the small intestine), can cause projectile vomiting in infants around this age.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Intussusception: A serious condition where a part of the intestine slides into an adjacent part, potentially leading to bowel obstruction and necrosis. Vomiting can be an early symptom, along with abdominal pain and bloody stools.
- Volvulus: A condition involving the twisting of a portion of the intestine, which can cut off blood flow and lead to tissue death. Symptoms can include severe vomiting, abdominal pain, and bloody stools.
- Ingestion or poisoning: Although less common in infants, accidental ingestion of harmful substances can lead to severe vomiting among other symptoms.
- Rare diagnoses:
- Metabolic disorders: Certain metabolic conditions can present with vomiting in infancy. These are rare but critical to diagnose early for proper management.
- Congenital infections: Infections acquired during pregnancy, such as congenital CMV, can present with non-specific symptoms including vomiting.
- Structural anomalies of the GI tract: Conditions like esophageal atresia or tracheoesophageal fistula, though usually diagnosed early in life, can sometimes present with vomiting if not immediately apparent at birth.