muntah pada anak

Muntah pada baby.

Definisi

• Vomiting : ejeksi secara paksa isi lambung dan usus (chyme) lewat mulut. Biasanya diransang:

- overstretching lambung dan usus- alkohol- bacterial toxins- trauma visceral ( terutama organ pelvis)- psikologis.

Mekanisme

Stimulus stimulates emetic center in medula oblongata via afferent nerves

Nausea , retching:- Thoraxic expansion

- Abd contraction- Dilatasi esofagus

- Lower esophageal relaxes

Chyme enters esophagusRising thoraxic pressure ,

forcefullly open the upper esophageal sphincter.

Expulsion of food. ( vomiting)

Innervation of stomach

EtiologiInfant Child Adolescent

• Gastroenteritis• Gastroesophageal reflux• Overfeeding• Anatomic obstruction• Systemic infection• Aerophagia• Intussuseption• Pertussis syndrome• Otitis media

• gastroenteritis• Systemic infection• Gastritis• Toxic ingestion• GERD• Sinusitis

•gastroenteritis• Systemic infection• Gastritis• Toxic ingestion• GERD• Appendicitis• Migraine• Pregnancy

Cyclic vomiting

• Syndrome with numerous episodes of vomiting interspersed with well intervals.

• Onset is usually 2-5 years of age• Frequency about 10-12 episode per year• Each episode last 2-3 days• May have prodrome: paleness, intolerance to

light and noise, nausea, lethargy• Precipitated by: infection, stress , excitement.

Projectile vomiting

• Vomiting that occurs without nausea and retching.

• Usually have neurological causes: Increase in intracranial pressure

Treatment • Domperidone:

- peripheral dopamine receptor antagonist- dosis : 0.25-0.6mg/ kgbb/ 3x1- vometa

• Metoclopramide:- dopamin antagonis, meransang pengosongan lambung dan peristaltik- dosis : 0.5-1mg/kgbb/ 3x1- vomitrol

komplikasi

• Dehidration• Alkalosis, hypochloremia• Hyponatremia, hypokalemia• Malnutrisi (failure to thrive)• Malory weiss tears • Aspiration Pneumonia• Shock due to severe fluid loss during vomiting