Differential Diagnosis for Emesis in a Three-Month-Old Infant
- The following differential diagnosis is organized into categories to guide the assessment of a three-month-old infant presenting with emesis.
Single Most Likely Diagnosis
- Gastroesophageal Reflux (GER): This is the most common cause of emesis in infants, where stomach acid flows back into the esophagus, leading to vomiting. It is often associated with feeding and can be exacerbated by position.
Other Likely Diagnoses
- Infectious Gastroenteritis: This is a common cause of vomiting in infants, often due to viral or bacterial infections. Symptoms may include fever, diarrhea, and abdominal distension.
- Food Protein-Induced Allergic Proctocolitis (FPIAP): This condition occurs when an infant's body reacts to a specific protein in their diet, leading to inflammation of the rectum and vomiting.
- Overfeeding or Underfeeding: Improper feeding techniques or volumes can lead to emesis in infants.
- Pyloric Stenosis: A condition where the pylorus muscle thickens, blocking food from entering the small intestine, leading to projectile vomiting.
Do Not Miss Diagnoses
- Hirschsprung's Disease: A congenital condition where nerves are missing from parts of the bowel, leading to intestinal obstruction and vomiting.
- Intussusception: A condition where a part of the intestine slides into another, causing bowel obstruction and potentially life-threatening complications.
- Infectious Meningitis: Although less common, meningitis can present with non-specific symptoms like vomiting in infants, and it is crucial to consider this diagnosis to avoid missing a potentially fatal condition.
- Hypertrophic Pyloric Stenosis with Gastric Outlet Obstruction: Similar to pyloric stenosis but with more severe consequences if not promptly diagnosed and treated.
Rare Diagnoses
- Cyclic Vomiting Syndrome: A rare condition characterized by recurring episodes of vomiting with no apparent cause.
- Congenital Adrenal Hyperplasia: A group of genetic disorders affecting the adrenal glands, which can lead to vomiting among other symptoms.
- Gastropoucheritis: Inflammation of the stomach and duodenum, which can cause vomiting.
- Congenital Gastrointestinal Anomalies: Various anomalies such as duodenal atresia, which can cause intestinal obstruction and vomiting.