Differential Diagnosis for Pediatric Vomiting

Single Most Likely Diagnosis

• Viral Gastroenteritis: This is the most common cause of vomiting in children, often accompanied by diarrhea, fever, and abdominal cramps. The high incidence of viral infections in pediatric populations and the typical presentation make this the leading consideration.

Other Likely Diagnoses

• Food Poisoning: Similar to viral gastroenteritis, food poisoning can cause vomiting, diarrhea, and abdominal pain, usually after consuming contaminated food or drinks.
• Gastroesophageal Reflux Disease (GERD): Common in infants and young children, GERD can lead to vomiting, especially after feeding.
• Urinary Tract Infection (UTI): While more common in girls, UTIs can cause vomiting, fever, and abdominal pain in children.
• Constipation: Sometimes, constipation can lead to vomiting, especially if the constipation is severe and leads to abdominal distension.

Do Not Miss Diagnoses

• Appendicitis: Although less common in very young children, appendicitis is a surgical emergency that can present with vomiting, abdominal pain, and fever. Missing this diagnosis can lead to severe consequences.
• Intussusception: A condition where a part of the intestine slides into an adjacent part, intussusception is a medical emergency that can cause vomiting, bloody stools, and abdominal pain.
• Pyloric Stenosis: Typically presenting in the first few months of life, pyloric stenosis causes projectile vomiting and can lead to severe dehydration if not promptly treated.
• Meningitis: While less common, meningitis can present with vomiting, fever, and signs of irritation, such as a bulging fontanelle in infants.

Rare Diagnoses

• Inborn Errors of Metabolism: Certain metabolic disorders can cause vomiting, among other symptoms, due to the body's inability to properly metabolize nutrients.
• Food Allergies: Allergic reactions to food can cause vomiting, diarrhea, and abdominal pain, though they are less common than other causes.
• Increased Intracranial Pressure: Conditions that increase pressure inside the skull, such as a brain tumor, can cause vomiting, especially in the morning.
• Adrenal Insufficiency: A rare condition where the adrenal glands do not produce enough hormones, which can lead to vomiting, among other symptoms.