Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three patients with Boerhaave syndrome were successfully managed with nonoperative treatment. The diagnosis was delayed 5 days in one patient and 10 days in the other two. None of the patients appeared septic. Their conditions had been misdiagnosed as myocardial infarction, pneumonia and pulmonary embolism. Treatment consisted of intravenous hyperalimentation and administration of antacids and antibiotics. Cimetidine was also used in one patient. Two patients were discharged 14 days after diagnosis and the third on the 20th hospital day. Follow-up barium swallows showed complete healing in 2 months in all three patients. Conservative management of spontaneous esophageal perforation is feasible when (1) the perforation is already 5 days old, (2) there are no signs of severe sepsis, (3) esophageal barium study shows a wide-mouthed cavity draining freely back into the esophagus, and (4) the pleural space is not contaminated. When the diagnosis is made promptly, surgical therapy remains the treatment of choice, and patients managed conservatively who show signs of sepsis should be operated on without hesitation. Follow-up esophageal evaluation should be performed to confirm complete healing and to evaluate underlying disease.
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PMID:Boerhaave syndrome. Successful conservative management in three patients with late presentation. 678 84

Anorexia nervosa (a.n.) is a mental disorder connected with the high mortality coming up to 18%. The death causes are suicide and somatic complications resulting from cachexy, laxatives and diuretics abuse, which occurs in some patients and from vomiting provocation. The digestive tract complications are considered to be the death causes in a.n, as well. Among the surgical complications, which usual occur in the initial period of the intensive nutrition the most serious and frequent ones are oesophageal rupture in the course of vomiting provocation (Boerhaave's syndrome) and the syndrome of compression of the horizontal part of the duodenum, by the mesentery (superior mesenteric artery syndrome) leading to the gastrectasia and possible gastric necrosis and perforation. In this paper the review of the current literature concerning the digestive tract complications in a.n. has been made. Also, the courses of the diseases and the complications requiring surgical intervention in 3 patients treated between 1998 and 2000 in the Department of Child Psychiatry and the Department of Cardiosurgery of the Medical University of Warsaw have been discussed. The patients developed segmental enteritis, gastrectasia caused by the superior mesenteric artery syndrome and small intestine strangulation. The early surgical intervention in the latter case and the proper maintenance treatment in two other ones allowed to avoid more serious complications. The authors postulate profound analysis of the abdominal complaints from the point if view of surgical complications in anorectic patients in the initial period of their hospital treatment and consideration of the complete parenteral hyperalimentation in the extremely debilitated to avoid life threatening digestive tract complications.
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PMID:[Surgical complications occurring during hospitalization of patients with anorexia nervosa--literature review and a discussion of three cases]. 1229 87