Approach to the vomiting child

A 5-week-old boy, first child, has had one week of vomiting that occurs within 30 minutes of every feed and is now forceful, landing well away from him. The vom…

Pre-internship · middle twist

An 8-month-old previously well boy has had a 12-hour history of episodes in which he suddenly screams, draws his knees up to his chest and goes pale, lasting a…

Clinical rotations · common

A previously well 2-year-old boy has passed two large, dark red stools today. He has had no abdominal pain, has not drawn up his legs, has not vomited and has h…

Clinical rotations · middle twist

You are the resident covering an after-hours paediatric telephone line. The mother of a two-year-old boy rings about his second day of gastroenteritis. He was r…

Pre-internship · common

A 5-week-old boy has vomited after feeds for three weeks. The milk now comes back forcefully enough to reach the floor, and he immediately wants to feed again.…

Clinical rotations · middle twist

A 5-week-old boy is admitted after a fortnight of vomiting that now shoots across the change table after every feed. The vomit has never been green. He feeds hu…

Pre-internship · middle twist

A 7-month-old girl has had six hours of episodes in which she suddenly screams, draws her knees up and stiffens for a minute or two, then lies pale and floppy u…

Clinical rotations · middle twist

A 4-day-old term boy, discharged home yesterday and feeding well until this morning, has vomited four times in six hours. The vomit is dark green. He passed mec…

Clinical rotations · middle twist

A 7-month-old previously well boy is brought to the emergency department after six hours of episodes of sudden inconsolable screaming during which he draws his…

Clinical rotations · common

A 6-day-old boy born at term is brought to the emergency department after vomiting three times over four hours; the most recent vomitus was dark green. He fed n…

Clinical rotations · middle twist