Differential Diagnosis for Vomiting in a 5-Month-Old
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 age of the infant and the nature of the vomiting (often after feeding) support this diagnosis.
Other Likely Diagnoses
- Viral gastroenteritis: This is a common cause of vomiting in infants, often accompanied by diarrhea and fever. The highly contagious nature of viral gastroenteritis and the exposure history of the infant are important considerations.
- Overfeeding or feeding intolerance: Infants who are fed too much or have difficulty digesting certain formulas may vomit. This diagnosis is supported by a history of recent changes in feeding patterns or formula.
- Pyloric stenosis: Although less common, this condition, which involves narrowing of the pylorus (the passage between the stomach and small intestine), can cause projectile vomiting in infants, typically after feeding.
Do Not Miss Diagnoses
- Intussusception: A serious condition where a part of the intestine slides into another, which can cause severe vomiting, abdominal pain, and bloody stools. It's crucial to consider this diagnosis due to its potential for severe complications if not promptly treated.
- Volvulus: A condition involving the twisting of a portion of the intestine, which can cut off blood flow and lead to severe vomiting, abdominal pain, and potentially life-threatening complications.
- Ingestion of a foreign body or toxic substance: Infants may accidentally ingest harmful substances, which can cause vomiting among other symptoms. Prompt identification and treatment are critical.
Rare Diagnoses
- Metabolic disorders: Certain metabolic conditions, such as pyloric stenosis due to metabolic disorders, can present with vomiting. These are less common but important to consider if other diagnoses are ruled out.
- Congenital anomalies of the gastrointestinal tract: Conditions like esophageal atresia or tracheoesophageal fistula, though typically diagnosed in the neonatal period, could potentially present later with vomiting if less severe or if there are complicating factors.
- Increased intracranial pressure: Though rare in this age group, conditions that increase pressure inside the skull, such as hydrocephalus or brain tumors, can cause vomiting. This would be considered in the context of other neurological signs or symptoms.