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Gastroenteritis, Emergency Medicine

Isam F. Nasr Reviewed 06/2017
 


Basics

Description

Inflammation of stomach and intestines associated with diarrhea and vomiting; often the result of infectious or toxin exposure. 

Etiology

Infectious

  • Viruses:

    • 50–70% of all cases with Nor...

Diagnosis

Signs and Symptoms

History

  • Nausea, vomiting, diarrhea

  • Bloody/mucous diarrhea

  • Abdominal cramps or pain

  • Fever

  • Malaise, myalgias, headache, anorexia

  • Hypotension, lethargy, and dehydration (severe case...

Treatment

Pre-Hospital

  • Difficult IV access with severe dehydration.

  • Avoid exposure to contaminated clothes or body substances.

Initial Stabilization/Therapy

  • Management of ABCs

  • IV fluid with 0.9% NS resusci...

Follow-Up

Disposition

Admission Criteria

  • Hypotension unresponsive to IV fluids

  • Significant bleeding

  • Signs of sepsis/toxicity

  • Intractable vomiting or abdominal pain

  • Severe electrolyte imbalance

  • Metabolic acid...

Pearls and Pitfalls

  • Viruses account for over 50% of cases

  • Avoid antimotility drugs in cases due to infectious pathogens.

  • TMP–SMX (Bactrim DS), ciprofloxacin, doxycycline, and tetracycline are contraindi...

Additional Reading

  • Bresee  JS, Marcus  R, Venezia  RA, et al. The etiology of severe acute gastroenteritis among adults visiting emergency departments in the United States. J infect Dis.  2012;20...

Codes

ICD9

  • 008.63 Enteritis due to norwalk virus

  • 009.0 Infectious colitis, enteritis, and gastroenteritis

  • 558.9 Other and unspecified noninfectious gastroenteritis and colitis

  • 008.43 Intestinal infection ...

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