Science and Education Publishing American Journal of Medical Case Reports 2374-216X 3 11 2015 11 3 Hematemesis in a Child on Olanzapine 380 382 EN Richard Pescatore DO Department of Emergency Medicine, Cooper University Hospital, Camden, NJ Dunisha Ranasuriya MD Lisa Drago DO Julie Whitney DO Sandra Nairn DO AJMCR20153119 10.12691/ajmcr-3-11-9 2015 6 10 2015 8 17 2015 11 1 The case of a 13-year old boy with hepatic steatosis secondary to atypical antipsychotic use is described. The patient presented with a single episode of moderate-volume hematemesis and was found to have severe fatty infiltration and ductal dilatation of the liver. These changes were attributed to the patient's use of olanzapine for behavioral disorders related to autism spectrum disorder. The differential diagnosis of pediatric hematemesis is described, as well as the importance of considering adverse drug affects in patients maintained on olanzapine and other antipsychotics.