Projectile vomiting is a condition that is classically associated with having increased intracranial pressure, a congenital condition called hypertrophic pyloric stenosis, or a condition called gastric outlet obstruction. Patients with projectile vomiting throw up the content of their stomachs with great force, often causing the gastric contents to travel a significant distance after leaving the mouth. Any patient with severe vomiting should be sure to check with a doctor or other health care professional in order to best determine the cause of the vomiting.
One of the most life-threatening causes of this type of vomiting is having increased intracranial pressure. The cranium, made of bone, only contains a limited amount of space for its contents, including the brain, linings of the brain, and cerebrospinal fluid (CSF). A number of conditions can cause a pathologic increase in the pressure inside the brain, including brain tumors, the presence of excess CSF, meningitis, encephalitis, or bleeding in the brain. The increase in the pressure inside the cranium irritates the part of the brain the controls the process of vomiting, stimulating affected patients to have the onset of sudden, forceful vomiting. Other symptoms of increased intracranial pressure can include headaches, especially early in the morning, blurred vision, and confusion.
Young infants can be affected by a condition called hypertrophic pyloric stenosis, which is another classic cause of projectile vomiting. Infants typically develop this condition in the first few weeks of life, and have symptoms including vomiting, weight loss, and poor sleep. It is a congenital condition in which the pyloric muscle of the stomach, which helps control the passage of food from the stomach into the intestines, becomes over-developed and inhibits the proper passage of food. The condition is diagnosed either by feeling this enlarged muscle by palpating the abdomen, or by the use of ultrasound imaging. It is easily cured by surgery.
Adults and older children can also develop this type of vomiting if the flow of food from the stomach into the intestines is impeded. This condition is generally known as gastric outlet obstruction. It can develop as a result of gastric cancer, intestinal cancer, peptic ulcer disease, lymphoma, tuberculosis, hemochromatosis, and amyloidosis. Curing this condition relies on treating the underlying disease.
Although projectile vomiting is mostly closely linked to the three conditions described above, other causes of vomiting could rarely cause this type. For example, viral gastroenteritis typically causes non-projectile vomiting. In severe cases, however, expulsion of substance from the stomach could be particularly forceful, and thus projectile in nature.