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Obstruction & Vomiting

Vomiting: causes

GI
- SBO / LBO (small bowel obstruction / large bowel obstruction)
- gastroenteritis
- mucosal lesions: gastritis / GU / DU

Neurogenic
- raised­ ICP (intra-cranial pressure)
- vestibulo-cochlear disease
- pyschogenic: pain, fear, anxiety

Inflammatory
- peritoneal inflammation: hepatitis, pancreatitis
- infection elsewhere: sepsis, pneumonia
- cancer

Metabolic: U&Es
- raised Ca²⁺
- ­raised urea
- decreased Na ⁺

Metabolic: endocrine
- Addison’s
- DKA (diabetic keto-acidosis)

- pregnancy

Drugs
- EtOH

- chemotheraputic agents
- opiods
- antibiotics

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Vomiting: investigation

Urinalysis
- DKA
- UTI

Bloods
- FBC
- CRP

- U+Es - Ca²⁺

- LFTs
- amylase

Endocrinology
- short synACTHen

Radiology
- CXR: pneumonia, aspiration pneumonia, cancer
- AXR: SBO / LBO (small/large bowel obstruction)

Special
- OGD: small bowel meal (subacute SBO)
- CT head

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Vomiting: management

Conservative
- fluids
- treat cause

Drugs
- antiemetics

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