Abdominal Pain and Vomiting in the Infant

Grover, Casey MD
Wang, Ewen MD
Erbrich, Nick MD

¹Stanford/Kaiser Emergency Medicine Residency, Stanford, CA.
²Associate Professor of Surgery/Emergency Medicine, Associate Director, Pediatric Emergency Medicine, Stanford School of Medicine, Stanford, CA.
³FAAP, Department of Emergency Medicine, St. Christopher's Hospital for Children, Philadelphia, PA.

Pediatric Emergency Medicine Reports 16(10):p 117-127, October 2011.

Abdominal pain with vomiting is a common presenting complaint to the emergency department (ED) in infants. In the majority of cases, the patient’s symptoms come from a benign cause such as gastroenteritis. However, it remains essential for the emergency physician (EP) to thoroughly understand the differential diagnosis of abdominal pain and vomiting in infants, particularly identifying those causes requiring surgical intervention.This article will discuss seven key causes of abdominal pain and vomiting in infants: malrotation with volvulus, necrotizing enterocolitis, Hirschsprung’s disease, pyloric stenosis, intussusception, appendicitis, and acute gastroenteritis. A summary of the presenting age and frequency of each condition is displayed inTable 1for quick reference.

***Table 1.*** Presenting Age and Frequency of Conditions Causing Abdominal Pain and Vomiting in Infants
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—The Editor

Executive Summary

Bilious vomiting is a hallmark feature of malrotation with volvulus.
NEC is a disease in neonates associated with prematurity and hypoxia, occurring in up to 12% of infants weighing less than 1500 grams.
The cardinal presenting symptom in Hirschsprung’s disease is delayed passage of meconium.
Lethargy is a common presentation of intussusception.

Abdominal Pain and Vomiting in the Infant

Table 1. Presenting Age and Frequency of Conditions Causing Abdominal Pain and Vomiting in Infants

Executive Summary