Heterogeneity of diagnoses presenting as cyclic vomiting. Pediatrics 1998 Sep;102(3 Pt 1):583-7
Date
09/17/1998Pubmed ID
9738180DOI
10.1542/peds.102.3.583Scopus ID
2-s2.0-0031690097 (requires institutional sign-in at Scopus site) 72 CitationsAbstract
OBJECTIVE: To establish the diagnostic profile in children who present with cyclic vomiting.
METHODS: We studied 225 children < 18 years of age who presented to our pediatric gastroenterology service from 1986 to 1997 with at least three discrete episodes of vomiting between which they were well. To determine the diagnoses in those presenting with a pattern of cyclic vomiting, the results of diagnostic testing and responses to various treatments were obtained from a combination of chart review and structured telephone interviews.
RESULTS: The largest diagnostic category included idiopathic cyclic vomiting syndrome (88%). Extraintestinal disorders (7%) and gastrointestinal disorders (5%) constituting the probable cause of vomiting were established in those having complete cessation of episodes after therapy. In 12%, serious surgical disorders of the gastrointestinal (malrotation), renal (acute hydronephrosis), and central nervous systems (neoplasm) were found. In 2%, serious endocrine (Addison's disease) and metabolic disorders (disorder of fatty acid oxidation) were found. Among those with idiopathic cyclic vomiting syndrome, 41% had associated disorders (gastroesophageal reflux and chronic sinusitis) that could contribute to the vomiting, but, based on a partial response to therapy, were not deemed to be the main cause. Altogether 49% had an identified disorder that probably caused or could contribute to the vomiting.
CONCLUSIONS: The cyclic pattern of vomiting is a symptom complex that can be induced by heterogeneous disorders that either cause or contribute to the vomiting. Once the cyclic vomiting pattern is identified, systematic diagnostic testing is warranted to look for these underlying disorders.
Author List
Li BU, Murray RD, Heitlinger LA, Robbins JL, Hayes JRAuthor
B Ulysses Kwang Li Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Central Nervous System DiseasesChild
Child, Preschool
Female
Gastrointestinal Diseases
Humans
Kidney Diseases
Male
Periodicity
Syndrome
Vomiting
