Red flags vomiting

Question 1

Bile-stained vomit

Answer 1

Intestinal obstruction

Vomiting is persistent and is bile stained unless the obstruction is above the ampulla of vater

Question 2

Haematemesis

Answer 2

Oesophagitis
Peptic ulceration
Oral/nasal bleeding
Oesophageal variceal bleeding

Question 3

Projectile vomiting in the first few weeks of life

Answer 3

Pyloric stenosis

Question 4

Abdominal tenderness/abdominal pain on movement

Answer 4

Surgical abdomen

Question 5

Abdominal distension

Answer 5

Intestinal obstruction, including strangulated inguinal hernia

Question 6

Hepatosplenomegaly

Answer 6

Chronic liver disease, inborn error of metabolism

Question 7

Blood in the stool

Answer 7

Intussusception, bacterial gastroenteritis

Question 8

Severe dehydration, shock

Answer 8

Severe gastroenteritis
Systemic infection (UTI/Meningitis)
DKA

Question 9

Bulging fontanelle or seizures

Answer 9

Raised ICP

Question 10

Faltering growth

Answer 10

GORD
Coeliac disease
Chronic gastrointestinal conditions