Differential Diagnosis for Vomiting in a 2-Year-Old
Single Most Likely Diagnosis
- Viral Gastroenteritis: This is the most common cause of vomiting in children, often accompanied by diarrhea, and is usually self-limiting. The high frequency of viral infections in this age group, coupled with the typical presentation of vomiting and diarrhea, makes this the leading diagnosis.
Other Likely Diagnoses
- Food Poisoning: Similar to viral gastroenteritis but typically results from consuming contaminated food or drinks. Symptoms can be more severe and may include fever and abdominal cramps.
- Urinary Tract Infection (UTI): Although more common in girls, UTIs can cause vomiting in young children, especially if the infection involves the kidneys (pyelonephritis).
- Acute Appendicitis: While less common in very young children, appendicitis should be considered, especially if vomiting is accompanied by abdominal pain, fever, and lethargy.
- Gastroesophageal Reflux Disease (GERD): Can cause vomiting, especially after feeding, in infants and toddlers.
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 medical emergency and can present with vomiting, abdominal pain, and bloody stools.
- Pyloric Stenosis: A condition where the pylorus (the passage between the stomach and small intestine) thickens, blocking food from entering the intestine. It typically presents with projectile vomiting in infants.
- Meningitis: An infection of the membranes surrounding the brain and spinal cord. Vomiting can be a symptom, especially if accompanied by fever, headache, and stiff neck.
- Diabetic Ketoacidosis (DKA): A serious complication of diabetes that can cause vomiting, dehydration, and altered mental status.
Rare Diagnoses
- Congenital Anomalies of the Gastrointestinal Tract: Conditions such as duodenal atresia or stenosis can cause vomiting, especially in the first few weeks of life.
- Inborn Errors of Metabolism: Certain metabolic disorders can present with vomiting among other symptoms, due to the body's inability to properly metabolize nutrients.
- Brain Tumors: Although rare, brain tumors can cause increased intracranial pressure, leading to vomiting, especially in the morning.
- Adrenal Insufficiency: A condition where the adrenal glands do not produce enough hormones, which can lead to vomiting, among other symptoms like fatigue and weight loss.