examination of testes for torsion, particularly in adolescent boys.“tinkling” high-pitched or absent of bowel sounds may suggest gastrointestinal obstruction.abdominal distension could suggest acute abdomen or bowel obstruction (ask parent if abdomen changed in appearance).Other factors such as toxin ingestion/drug use, eating disorder, pregnancy Previous history of previous GIT obstruction or surgery Swallowed blood (eg epistaxis, or in neonate from maternal blood due to delivery or nipple trauma)Ībdominal distension and tenderness, “tinkling”/absence of bowel sounds Symptoms and signs associated with possible diagnoses (table below is not an exhaustive list and presentations can overlap) Nature of vomiting Early morning vomiting and headache may be due to raised intracranial pressure.Using a visual aid to clarify vomitus colour with families is helpful Bilious vomiting occurs when there is a gastrointestinal obstruction.Infection is the most common cause of acute vomiting.Vomiting is a common and non-specific symptom, not a diagnosis.Ondansetron can be used for symptomatic relief, however cessation of vomiting does not exclude a serious cause.Intracranial causes eg non-accidental injury (NAI), should always be considered.In a vomiting child without diarrhoea, consider causes other than gastroenteritis.Bilious (dark green) vomiting is due to a gastrointestinal obstruction until proven otherwise, and requires urgent surgical referral.Besides the vomit, having trouble swallowing or feeling weak with no explanation can be further proof of an injury in the esophagus. A bigger problem is if the vomit is red, a sign of fresh blood and if there is a large wound somewhere in the GI tract. It is good that the vomit is black since it is clotting and the bleeding is slow. The result is that a person will regularly vomit in black. For example, a wound in the esophagus can continuously bleed into the stomach. It could be a minor damage to the esophagus that seeped into the stomach. It only means that there is bleeding somewhere in the tract. The situation doesn’t have to be that bad. Bleeding in the lower GI tract will appear in feces, while the upper GI ends at the stomach and the other end. ![]() ![]() Upper GI Tract BleedingĬlotted blood is the reason for the dark color, and the most common cause of that blood in the stomach is bleeding somewhere in the upper gastrointestinal tract. Here are some possible causes for the dark color. Vomiting blood like this is often a sign of a severe condition, necessitating to go to the doctor immediately for a diagnosis. This substance is clotted blood, and the black color of the vomit is because blood darkens when it clots. It is the reason why doctors often call this condition coffee ground vomitus. Instead of being watery, it looks like ground coffee and has the same dark or black color. ![]() It is not just the color but the consistency of it that is worrying. However, one of the worst possible colors of vomit that can appear is black vomit. Green and yellow are also possible colors for a person’s vomit. It is very treatable and will require only a bit of rest and some medication. Clear vomit is the simplest and is a simple reaction to food poisoning or even morning sickness. However, the color of the vomit can hint at how severe the problem is. It can mean a variety of conditions that a person is suffering from. Vomiting is always a bad sign since it is the body’s natural self-defense against toxins in the stomach.
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