Small Animal Emergency and Critical Care Medicine: Self-Assessment Color Review, Second Edition, Q&A 09

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Student tip: This case is useful for showing localization of vomiting.

Historical data and physical examination findings can help initial characterization of the GI pathology in the vomiting patient.

Question	Answer		Article
Match the color and content of the vomitus with the likely location of GI pathology and any possible characterization of the problem. Vomitus: White or clear foamy; Blood streaked white liquid; Dark ‘coffee grounds’; Yellow liquid; Green liquid; Dark brown fetid liquid; Bright red bloody liquid Possible location: Stomach; Upper duodenum; Lower duodenum/ileus; Upper ileum Potential pathology: Acute onset; Intestinal obstruction; Ulceration	White or clear foamy: stomach; typically acute. Blood streaked white liquid: gastric irritation from vomiting. Dark ‘coffee grounds’: pathologic gastric bleeding, ulceration; metabolic cause possible. Yellow liquid: stomach, digested reflux bile; not acute; metabolic cause possible. Green liquid: upper duodenum, reflux of bile; ileus/obstruction; typically acute. Dark brown fetid liquid: lower small bowel; ileus/total obstruction. Bright red bloody liquid: gastric hemorrhage; acute bleed; ulceration.		Link to Article
Complete the chart above (Localization of vomiting) with the following options (use each once only): peripheral receptor input; gastric atony; gastric/esophageal reflux; GDV; pyloric outflow obstruction; gastric/upper duodenal ileus; or outflow obstruction.	Retching with abdominal palpation: Peripheral receptor input. Passive efforts; no abdominal contractions: Gastric/esophageal reflux. Vomiting undigested food (≤6 hours): Gastric atony, pyloric obstruction. Projectile force of vomiting: Pyloric/upper duodenal ileus or outflow obstruction. Non-productive vomiting efforts: GDV.		Link to Article

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