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The Vomiting Neonate: A Review of the ACR Appropriateness Criteria and Ultrasound’s Role in the Workup of Such Patients

Blumer, Steven L. BS*; Zucconi, William B. DO†; Cohen, Harris L. MD‡; Scriven, Richard J. MD§; Lee, Thomas K. MD§

Original Articles: CME Article

Ultrasound (US) plays a central role in the diagnostic imaging workup for infantile vomiting. This paper reviews the major causes of vomiting in the first months of life and the use of US and other modalities for their imaging assessment. The differential diagnostic possibilities are reviewed by examining 3 clinical scenarios of bilious vomiting during the first days of life, nonbilious vomiting since birth, and projectile vomiting first occurring after several weeks of life. These are the 3 scenarios that were used for the American College of Radiology (ACR) Appropriateness Criteria for Vomiting in Infants up to 3 Months of Age.

*Medical Student, †Resident, Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY; ‡Professor of Radiology, Division of Body Imaging, Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY; and §Assistant Professor, Division of Pediatric Surgery, Department of Surgery, Stony Brook University School of Medicine, Stony Brook, NY.

Received for publication March 4, 2004; accepted April 16, 2004.

The authors have disclosed that they have no interests in or significant relationships with any commercial companies pertaining to this educational activity.

Reprints: Harris L. Cohen, MD, 78 Grove Avenue Cedarhurst, NY 11516-2311 (e-mail: hcohenmb@optonline.net).

© 2004 Lippincott Williams & Wilkins, Inc.