Evaluation of cyclic vomiting pattern in children older than 2 years

CVS: cyclic vomiting syndrome; NA: sodium; K: potassium; Cl: chlorine; HCO₃: serum bicarbonate; BUN: blood urea nitrogen; UGI: upper gastrointestinal; ALT: alanine aminotransferase; GGT: gamma-glutamyl transpeptidase; IV: intravenous; MRI: magnetic resonance imaging.
* Another set of criteria was developed by the Rome foundation in 2016 (Rome IV criteria), which has higher sensitivity and lower specificity compared with the NASPGHAN criteria^[1].
¶ May not need metabolic evaluation.
Δ Bilious vomiting is reasonably common in CVS. Surgical consultation is appropriate if the patient has additional radiographic or physical signs of intestinal obstruction.