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Frequent vomiting, appendix removed, blood filled vomit. Treatment ?

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Internal Medicine Specialist
Practicing since : 1998
Answered : 1579 Questions
Hi my 9yr old has intermittent vomiting for last 6 weeks. He had his appendix removed 13 days ago and it was inflammed and swollen. His vomiting got better in hospital and stopped for 6 days. It is now back and tonight it is dark brown. I called the surgeon today and explained that he was still vomiting and last night vomited for 2 hrs and was brown but it was last and I wasn't thinking. I am worried it is a form of blood in his vomit. He is in no pain except for this vomiting. He is asleep at the moment as it is night time. Could this be an ulcer ? I am going to take him back to emergency in the morning as the hospital wont do anything tonight as we were sent home three times with appendicitics before another dr saw him and it definainately was his appendix. The problem was tought to be solved but the vomiting still continues 13 days post op. ta
Posted Tue, 1 May 2012 in Child Health
Answered by Dr. Jasvinder Singh 22 minutes later

Thanks for posting your query. I can understand your concern for these symptoms because brown colored vomitus indicates blood in the vomiting and is called hematemesis. The farther the source of blood from the mouth, the darker the blood will be. One of the reasons can be ulcer. In children, the most common causes are gastric and duodenal ulcers, esophagitis, gastritis, and varices.

Since your son is having a history of chronic vomitings, hence XXXXXXX weiss tear (a tear in the mucosa layer of oesophagus) is an important possibility in your son’s case. Mallory-Weiss tears are most often caused by repeated vomiting, retching, or a vigorous bout of coughing.

Esophageal varices result can from portal hypertension, regardless of the age group. The increased resistance to blood flow through the portal system can be due to prehepatic, intrahepatic, and suprahepatic obstruction, but the most common causes of portal hypertension in children include portal vein thrombosis (prehepatic) and biliary atresia (intrahepatic).

I suggest you an immediate evaluation from a gastroenterologist as your son need upper GI endoscopy to rule out all these causes and a CT scan liver and biliary tree.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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