Differential Diagnosis for Projectile Vomiting
Single Most Likely Diagnosis
- Pyloric Stenosis: This condition, characterized by the narrowing of the pylorus, the passage between the stomach and small intestine, is a common cause of projectile vomiting in infants. The typical presentation of projectile vomiting after feeding, especially in a male infant around 2-8 weeks of age, makes pyloric stenosis the most likely diagnosis.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): While GERD more commonly presents with regurgitation rather than projectile vomiting, severe cases can lead to forceful ejection of stomach contents, especially in infants.
- Food Allergy or Intolerance: Allergic reactions to certain foods, such as milk protein allergy in infants, can cause vomiting, which may be projectile in nature.
- Infections (e.g., Viral Gastroenteritis): Though more commonly associated with diarrhea, certain viral infections can cause significant vomiting, occasionally projectile, especially in children.
Do Not Miss Diagnoses
- Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially cutting off blood supply. It's a surgical emergency and can present with vomiting, though abdominal pain and bloody stools are more characteristic.
- Appendicitis: While appendicitis typically presents with abdominal pain, nausea, and vomiting, the vomiting can occasionally be projectile, especially if the appendix is located near the stomach or small intestine.
- Increased Intracranial Pressure: Conditions such as brain tumors or hydrocephalus can cause projectile vomiting, often accompanied by other neurological signs like headache, altered mental status, or papilledema.
Rare Diagnoses
- Congenital Anomalies (e.g., Duodenal Atresia, Malrotation): These conditions can cause obstructive symptoms, including vomiting, which may be projectile, especially if the obstruction is near the stomach.
- Metabolic Disorders: Certain metabolic disorders can present with vomiting among other symptoms. While rare, they are important to consider in the differential diagnosis of projectile vomiting, especially if other signs like lethargy, seizures, or specific odors are present.