Peptic Ulcer DISEASE/GASTRITIS

Clinical Description

• look for underlying cause and treat accordingly
• Do not give symptomatic treatment without knowing the cause
• exclude mechanical obstruction
• Recognize that bilious or faeculent vomiting is a sign of mechanical obstruction
• These patients must be managed at a tertiary facility.
• correct dehydration as necessary

Treatment

• Give Metoclopramide 10 mg IV/IM or PO (if patient can keep food down)

Patients less than 20 years require special caution – they are at higher risk of developing extrapyramidal side effects from metoclopramide. Use alternative anti-emetic if available.

Children

• All children with profuse vomiting must be admitted for hydration, observation and investigation. When a guardian comes back with a child who is still vomiting, admit or refer the child. Do not send them home.
• All children with bilious vomiting should be referred 7.8. PAEDIATRIC SURGICAL EMERGENCIES