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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of mesenteric arteritis complicating the post-operative coarctectomy in a 5 day old infant is described. This case was of interest due to diagnostic difficulties and the fatal outcome. In order to avoid the disastrous consequences of this syndrome, the following symptoms including fever, intestinal bleeding, ileus, nausea, vomiting, leucocytosis, hypertension or abdominal pain should alert the physicians and treatment should start without delay.
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PMID:Postcoarctectomy mesenteric arteritis presenting as neonatal appendicitis. 51 13

Metoclopramide or placebo was administered postoperatively in a randomized, double-blind fashion to 115 patients undergoing laparotomy. The effect of metoclopramide on postoperative adynamic ileus (PAI) was evaluated. The patients were stratified into two groups: Group A--those with laparotomy without a gastrointestinal anastomosis or ostomy procedure, and group B--those with laparotomy undergoing an anastomosis or ostomy procedure. Metoclopramide reduced nausea and emesis postoperatively. However, the only significant effect on postoperative adynamic ileus was an earlier return to tolerance of solid foods in the patients in Group A.
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PMID:The effects of metoclopramide on postoperative ileus. A randomized double-blind study. 58 60

We presented 12 patients with invasive bladder cancer treated by the subselective intra-arterial COMPA chemotherapy. COMPA was administered up to an average of 3.3 courses (ranged from 2 to 6 courses) every 2 or 3 weeks, consisting of cisplatin: 15 mg/M2 on days 4 and 5; vincristine (oncovin): 0.6 mg/M2 on days 1 and 2; methotrexate: 5 mg/M2 on days 2 and 3; peplomycin: 5 mg/body on days 1, 2 and 3; and adriamycin: 10 mg/M2 on day 4. These were injected through a teflon catheter the tip of which was placed just proximal to the aortic bifurcation, and another tip was led through a subcutaneous tunnel from the inguinally punctured area to the anterior chest wall. The 12 patients, 7 men and 5 women, ranged in age from 53 to 73 (mean: 67) years. Histopathologically 11 had transitional cell carcinoma and one had adenocarcinoma. Malignant gradings were grade 2 in 8 patients, and grade 3 in 4. The stagings were T2 in 3 patients, T3 in 5, T4 in 4 and only one had bony metastasis. Of the 12 patients, 10 were alive at the last follow-up with a mean duration of 36 months (range: 16 to 49). Six patients achieved a complete remission, four achieved a partial remission and two were stable. One died of ileus after 16 months and another of progression after 36 months. All the patients received post-chemotherapeutic adjunctive therapies, which were transurethral resection, partial cystectomy, radiation and/or intravesical instillation. The toxicities were not severe, but anorexia, nausea, vomiting, hair loss, numbness of fingers and/or toes, subileus, and leukopenia were noticed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Intra-arterial COMPA chemotherapy for invasive bladder cancer]. 127 59

A 75-year-old black man came to the emergency room because of nausea, vomiting, abdominal pain, and distension and obstipation. An abdominal radiograph revealed a sigmoid volvulus. This was nonoperatively reduced in the emergency room. Following a mechanical and antibiotic bowel preparation, the patient underwent elective exploration. We report, for the first time, operative treatment of sigmoid volvulus with a laparoscopic-assisted sigmoid colectomy and primary anastomosis. Because of dense fibrous scarring of the sigmoid mesentery produced by chronic mesosigmoiditis, the redundant sigmoid was exteriorized and resected extracorporeally. A stapled, side-to-side, functional end-to-end anastomosis was constructed. The patient experienced little postoperative pain and virtually no postoperative ileus. We believe that laparoscopic-assisted sigmoid resection may offer distinct advantages for the treatment of the typically elderly, debilitated patient in whom sigmoid volvulus develops. Furthermore, because of the characteristic mesosigmoiditis associated with sigmoid volvulus, we suspect that exteriorization and extracorporeal resection may prove the easiest and most rapid laparoscopic approach to this disease.
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PMID:Laparoscopic-assisted sigmoid colectomy for sigmoid volvulus. 134 64

Complications of the initial 200 cases of laparoscopic cholecystectomy (LC) at the Cathay General Hospital within a period of 11 months were reviewed from video documents of the operations and clinical records. The major complication rate was 3.5%, including one common bile duct (CBD) injury (0.5%), three retained CBD stones (1.5%), one subphrenic fluid accumulation (0.5%), one liver abscess (0.5%) and one cystic duct stump bile leakage (0.5%). All major complications were cholecystectomy-related, and only one of the seven occurred in cases of acute cholecystitis. Age and sex were not related to its occurrence. The rate of minor complications ranged from 0.5% to 10%; they were: shoulder and back pain (10%), gall bladder perforation (10%), retained stones in the abdominal cavity (5%), transient nausea and diarrhea (5%), extension of umbilical port to a mini-laparotomy (3.5%), prolonged operation time > three hours (2%), subcutaneous emphysema (1.5%), wound infection (1.5%) and prolonged ileus (0.5%). The minor complications occurred largely in patients with acute cholecystitis. The complications occurred mostly during the early period of our study, indicating a learning period phenomenon. These could have been avoided if we had had a thorough knowledge of the potential complications and had strictly followed the principles of laparoscopic surgery. We conclude that LC is safe and the complication rate is not higher than that for open cholecystectomy. Most of the complications are preventable if LC is performed by qualified biliary surgeons following strict precautions.
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PMID:Complications of laparoscopic cholecystectomy: an analysis of 200 cases. 136 18

A 64-year-old woman visited my clinic with complaints of abdominal distension, constipation, and nausea. Since abdominal X-ray showed severe obstructive ileus following the upper GI barium swallow study, the patient was sent immediately to Saga Medical School Hospital for the emergency operation. As the result of the left hemicolectomy, two obstructive lesions were found at the sigmoid colon and the transverse colon. Nowadays, as the population of aged people increases and Japanese diet changes, colon cancers are increasing more rapidly. Since the half of colon cancers doesn't have any clinical symptoms of obstruction, the upper GI barium swallow study with condensed barium might lead a patient to some type of dangerous situation.
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PMID:[A case of obstructive ileus following the upper Gi barium swallow study with condensed barium due to severe constipation]. 139 23

A 50-year-old woman with a typical history of chronic idiopathic intestinal pseudo-obstruction was admitted to hospital because of an acute episode of abdominal cramps, nausea, and vomiting. The diagnosis of chronic idiopathic intestinal pseudo-obstruction had been established in this patient who had malnutrition and extreme weight loss as a result of severe malabsorption syndrome. The abdominal roentgenogram showed a typical hypotonic intestine with an enlarged stomach and distended intestinal loops with the radiological signs of an ileus. In addition to former episodes, there was also a transient aerobilia. The patient had not undergone biliary surgery or endoscopic sphincterotomy. To investigate the cause of the findings, endoscopic retrograde cholangiopancreatography and endoscopic manometry of the sphincter of Oddi were performed. The endoscopy showed the stomach and duodenum with a wide and dilated lumen and no spontaneous motility. Endoscopic manometry of the biliary tract and the sphincter of Oddi showed several abnormalities compared with a group of normal volunteers or patients who were examined via biliary manometry for other reasons. There was a low basal pressure (3.5 mm Hg) in the sphincter of Oddi together with low-amplitude phasic contractions (25-30 mm Hg), but the contraction frequency was in the normal range. Further investigations of the motility of the gastrointestinal tract in this patient showed diffuse esophageal spasms and a markedly delayed gastric emptying. The findings of biliary manometry in this patient suggest involvement of the sphincter of Oddi and the biliary system in chronic idiopathic pseudo-obstruction.
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PMID:Aerobilia and hypomotility of the sphincter of Oddi in a patient with chronic intestinal pseudo-obstruction. 129 27

The application of oral hyperosmolar contrast media, as they are used for the control of anastomoses after operations on the upper intestinal tract and for the diagnosis of ileus, is still controversial today because of possible side effects. We examined 53 patients postoperatively, after abdominal operations and within the framework of the diagnosis of ileus, to find out whether there were any problems with the fluid and electrolyte balance, and whether side-effects such as nausea, vomiting, pain and diarrhoea were still tolerable. The patients did not classify their subjective complaints as very serious. None of our patients showed clinically manifest disorders of the fluid and electrolyte balance. The increased frequency of bowel movement, caused by the contrast agent, was required for the treatment of postoperative bowel atonia and the condition of ileus or sub-ileus, if present. We still think the application of hyperosmolar contrast media can be justified, and hence we restrict the use of the much more expensive iso-osmolar contrast agents to patients who are at risk in respect to aspiration and unfit to cooperate.
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PMID:[Is the use of hyperosmolar oral contrast media still justifiable today?]. 157 78

Refractory epithelial ovarian cancer is generally confined to the peritoneal cavity and is thus amenable to intraperitoneal (ip) therapy. Radiolabeled monoclonal antibodies raised to tumor-associated antigens offer the promise of selective tumor irradiation while reducing toxicity to normal tissues. We have conducted a phase I therapeutic trial to examine the feasibility of ip radioimmunotherapy utilizing escalating doses of 131I-labeled OC125 F(ab')2. Twenty-nine patients were each treated with a single dose of radiolabeled antibody. Twenty-eight patients were evaluable for dose-related toxicity. The toxicities most frequently observed were hematologic and gastrointestinal. Hematologic toxicity was noted in 5/14 (36%) patients receiving 18-87 mCi and in 12/14 (71%) receiving 100-144 mCi (P = 0.018). The median white blood cell nadir of 2-3K/microliters (range, 1.4-3.5K/microliters occurred at a median of 4.5 weeks and the median platelet nadir of 41K/microliters (range, 20-78K/microliters) at a median of 6.5 weeks. Mild gastrointestinal toxicity was observed in 4/14 patients (28%) at doses less than 100 mCi whereas at doses greater than or equal to 100 mCi, 11/14 (79%) patients developed nausea, vomiting, or chronic ileus (P = 0.021). This toxicity occurred most frequently in patients with protracted urinary 131I excretion. We conclude that 131I-labeled OC125 can be safely administered ip. Hematologic and gastrointestinal toxicity is predictable and related to the dose and rate of clearance of isotope.
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PMID:Intraperitoneal radioimmunotherapy of refractory ovarian carcinoma utilizing iodine-131-labeled monoclonal antibody OC125. 161 2

The safety of laparoscopic cholecystectomy has been demonstrated through its increased use, and we have performed 114 of these operations as outpatient procedures. These patients have done well and hospitalization charges have been reduced substantially. Of 622 laparoscopic cholecystectomies performed from November 1989 to March 1991, 114 were done on an outpatient basis if the patients were generally healthy, lived nearby, and the operative procedure was uneventful. Other patients were admitted as 23-h observation or as inpatients. Records of 106 outpatients were reviewed and hospital charges obtained. These charges were then compared with those of 337 patients who underwent standard open cholecystectomy as morning admissions and who had no comorbid conditions nor complications. Comparisons are also made with 23-h observation and inpatient laparoscopic cholecystectomies as well as with all standard open cholecystectomy patients. The technique employed is with three punctures using electrocautery and a minimum of disposable products. Of the 106 outpatients, one required admission for postoperative ileus and pain control; 21 (19.8%) experienced nausea and 14 (13.2%) experienced vomiting but were treated successfully with antiemetics; none required admission. One patient required outpatient catheterization for urinary retention. Of the last 100 laparoscopic cholecystectomies performed by three surgeons (M.E.A., C.J.D., A.A.), 43 were performed as outpatients using the above selection criteria. 44 were held for 23-h observation, and 13 were inpatients. The average hospital charge for 377 uncomplicated morning-admitted inpatient standard cholecystectomy patients was $4,250.00, compared with $2,293.02 for 106 outpatient laparoscopic cholecystectomy patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:In selected patients outpatient laparoscopic cholecystectomy is safe and significantly reduces hospitalization charges. 166 12


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