Differential Diagnosis for Vomiting since Birth in an 18-month-old Baby
Single most likely diagnosis
- Gastroesophageal reflux disease (GERD): This condition is common in infants and can persist into toddlerhood, causing chronic vomiting due to the reflux of stomach contents into the esophagus.
Other Likely diagnoses
- Pyloric stenosis: Although typically presenting in the first few months of life, some cases might be diagnosed later, and it's a common cause of vomiting in infants.
- Food allergy or intolerance: Allergies to milk or other foods can cause chronic vomiting in infants and toddlers.
- Gastroenteritis: Recurrent episodes of gastroenteritis could lead to a history of vomiting since birth, especially if the baby is exposed to various pathogens.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Intussusception: A condition where a part of the intestine slides into another, which can cause intermittent vomiting and is a surgical emergency.
- Malrotation with volvulus: A congenital anomaly of the intestine that can cause bowel obstruction and ischemia, presenting with vomiting.
- Increased intracranial pressure: Conditions like hydrocephalus or brain tumors can cause vomiting, especially in the morning, and are critical to diagnose early.
Rare diagnoses
- Congenital infections (e.g., CMV, toxoplasmosis): These can cause a variety of symptoms including vomiting in infants.
- Metabolic disorders: Certain metabolic disorders can present with chronic vomiting among other symptoms.
- Eosinophilic esophagitis: A chronic inflammatory condition of the esophagus that can cause vomiting, especially after feeding.