TABLE 91.7 RED FLAG SIGNS AND SYMPTOMS IN CHILD WITH VOMITING Significant weight loss Fever Bilious, nocturnal or persistent emesis Lethargy GI bleeding (hematemesis, melena, bloody diarrhea) Hepatosplenomegaly Forceful vomiting Macro- or microcephaly, excessive increase in head circumference or bulging fontanelle Failure to thrive, weight loss Seizure Constipation/diarrhea Hyper- or hypotonia, Abnormal psychomotor development Recurrent pneumonia Onset