Metabolic and infectious disorders associated with emesis in infants.

Vomiting is associated with an endless array of medical and surgical conditions, including infectious and metabolic disorders. This article is designed to review the pathophysiological mechanism of vomiting in infants. There is tremendous overlap in the signs and symptoms associated with vomiting in infancy, and these will be described. Pertinent historical prospectives are examined including prenatal history, neonatal history, underlying conditions, recent or chronic medication usage, exposures to illnesses or toxin, and family history. Specific findings obtained during physical examination may help direct further assessment of the vomiting infant. Laboratory tests are essential to the evaluation of the infant with emesis. These studies serve not only to help assess the severity of illness in the vomiting infant, but also to aid in the appropriate collection and handling of specimens during the time of critical presentation that may be useful during what are often complex and confusing clinical courses. Therapeutic interventions including both specific and supportive modalities for infants with vomiting caused by infectious and metabolic disorders are discussed.