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

A case history of an 18-year-old woman admitted 2 days after undergoing a therapeutic abortion with acute abdominal pain is reported. The patient denied nausea or vomiting, but she appeared very ill with a temperature of 38.3 degrees centigrade. Pelvic examination was normal. The possibility of gonococcal perihepatitis was considered. When endocervical secretions were Gram-stained, gram-negative intracellular diplococci and neisseria gonorrhoeae were cultured. The patient had only 1 sexual partner, but that partner had had intercourse with at least 2 other women during the same period he was intimate with the patient. The patient responded to intravenous penicillin and was discharged after 5 days of treatment. It was suspected that dissemination of the gonococci was during the therapeutic abortion via the fallopian tubes. Neither the patient nor her partner, it was emphasized, showed genital symptoms, therefore the need to screen potential abortion patients is acute with gonorrhea at the epidemic stage.
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PMID:Occurrence of gonococcal perihepatitis after therapeutic abortion. 44 81

A case report of subacute, reversible ischemic colitis associated with use of oral contraceptives (OCs) is reported. A 19-year-old woman was admitted to the hospital with chief complaints of abdominal cramps, nausea, vomiting, diarrhea, and rectal bleeding of 2 days' duration. Past medical history and family history were noncontributory. The patient was receiving no medication other than Norinyl 2 (2 mg of norethindrone and .1 mg of mestranol), which she had been taking for 6 months. 2 days before admission the patient had taken 100 mg of dimenhydrinate and 2 ExLax tablets (90 mg of phenolphthalein) for constipation. Colonic roentgenograms revealed impaired mesenteric circulation and bowel ischemia; OC-induced ischemic bowel disease was diagnosed. Patient symptoms subsided within 96 hours of discontinuing the OC and initiating supportive therapy (including intravenous fluid infusion, nasogastric suction, analgesics, and antiemetics). When a repeat barium enema was performed, it showed resolution of the ischemia. In a short review following the case report, these drugs were indicted in causation of colitis-like syndrome: amoxicillin, ampicillin, cephazolin, chloramphenicol, chlorpropamide, clindamycin, cloxacillin, cotrimoxasole, cyclophosphamide, digitalis, ergotamine tartrate, flucytosine, fluorouracil, gold salts, laxative and cathartic abuse, mercurous chloride, methyldopa, penicillin V, and tetracycline. Ischemic bowel disease secondary to OC use is a rare but important complication because of its significant morbidity and potential mortality, and because of the widespread use of the drugs. The case report emphasizes the need to consider the differential diagnosis of acute vascular insult with bowel ischemia when acute abdominal pain progressing to bloody diarrhea occurs in young women taking OCs.
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PMID:Oral contraceptive-induced ischemic bowel disease. 48 72

A 58 year old Chinese male, one week after arriving in Canada from Hong Kong, presented with acute abdominal pain and diarrhoea which was rapidly followed by Escherichia coli infection causing septicaemia and meningitis. His past history revealed bronchial asthma for 15 years treated with steroids. At laparotomy, 7 days after the onset of symptoms, he was found to have extensive haemorrhagic infarction of the small bowel and right colon. Examination of the fibrosed mesenteric vessels revealed numerous filariform larvae of Strongyloides stercoralis, within the walls, and in all layers of bowel wall. The role of the parasite in the production of obliterative arteritis in this fatal case of haemorrhagic enteropathy is discussed. Clinical strongyloidiasis, in uncomplicated cases, varies from mild to severe with gastroenteritis, nausea, colicky abdominal pain, electrolyte imbalance and symptoms of malabsorption syndrome (MARCIAL-ROJAS, 1971). In malnourished individuals and patients with debilitating infections, either newly acquired or asymptomatic latent infection with S. stercoralis can assume severe dimensions (BROWN and PERNA, 1958; HUGHTON and HORN, 1959). Similarly, in patients on steroid (CRUZ et al., 1966; WILLIS and MWOKOLO, 1966; NEEFE et al., 1973) and immunosuppressive therapy for lymphomatous diseases or deficient in immune response (ROGERS and NELSON, 1966; RIVERA et al., 1970), systemic strongyloidiasis is often fatal. The increased frequency of auto-infection in such patients with a breached immune barrier is, however, unclear. Further complications of this infection due to severe enterocolitis result in sepsis, bacteraemia and meningitis (BROWN and PERNA, 1958; HUGHTON and HORN, 1959). This paper presents a fatal case of S. stercoralis infection which illustrates an uncommon if not unique, mechanism in its production of haemorrhagic enteropathy leading to sepsis and death.
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PMID:Fatal bowel infarction and sepsis: an unusual complication of systemic strongyloidiasis. 122 84

A 44-year-old man was admitted with acute abdominal pain, anorexia, nausea and dry retching, with tenderness and rigidity of the abdominal wall. Exploratory laparotomy revealed generalized peritonitis. He developed delerium tremens soon after operation and dehiscence of the abdominal wound 36 hours postoperatively. When the wound was closed and reinforced his recovery was uneventful. This case was unusual because he did not have ascites or cirrhosis, which are commonly associated with the disease.
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PMID:Spontaneous bacterial peritonitis in a healthy adult male. 220 34

A 36-year-old woman developed neutropenia following chemotherapy for inoperable carcinoma of the cervix. She suffered acute abdominal pain, nausea, vomiting, and peritonitis of rapid onset. The right hemicolon and 15 cm of terminal ileum were resected at laparotomy and this showed marked edema of the cecum and ileo-cecal valve associated with superficial ulceration of the valve. There was necrosis of submucosal tissues and the muscle wall which contained a large number of Gram-positive bacilli. These showed positive membrane immunofluorescence with specific anti-Clostridium septicum antisera. We identify a case of enterocolitis due to Clostridium septicum infection. This is associated with neutropenia and is often fatal due to the rapid course of and failure to recognize the infection.
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PMID:Clostridium septicum infection in neutropenic enterocolitis. 321 99

An elderly patient presenting with acute abdominal pain, nausea, and vomiting underwent a hepatobiliary scan. This demonstrated normal filling of the gallbladder but dilatation of the small bowel, which was found to correspond radiographically to partial small bowel obstruction.
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PMID:The cholescintigraphic pattern of small bowel obstruction. 382 53

This study analyzes the clinicopathologic findings in patients with ectopic pregnancy (EP), and deals with the differential diagnosis of the EP, intrauterine pregnancy (IUP), and pelvic inflammatory disease (PID). We evaluated 346 patients with suspected EP. Among those, 119 patients had EP, 82 had IUP, and 55 had PID without pregnancy. The incidence of EP was 1/32.9 live births. Comparing with the other groups, the patients with EP were slightly older, gave a history of previous pregnancies, had acute abdominal pain, nausea, vomiting, dizziness, and fainting, and had direct and rebound abdominal tenderness, pain on motion of the cervix, absence of a pelvic mass, and bilateral adnexal or cul de sac fullness. Culdocentesis was accurate in 95.1% of EP cases. Salpingectomy was performed in 89.9% of the patients with EP. The patients with EP had gross evidence of PID at the surgery in 31% and microscopic evidence of tubal inflammation in 19.4% of cases.
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PMID:Ectopic pregnancy. A prospective study on differential diagnosis. 726 61

There are increasing challenges for the practising gastroenterologist in treating AIDS-related gastrointestinal diseases. The differential diagnoses of dysphagia and odynophagia include cytomegalovirus (CMV) and herpes simplex virus (HSV) infection, non-specific aphthous ulceration and non-AIDS oesophageal diseases, especially reflux oesophagitis. Chronic subacute abdominal pain with nausea, vomiting, early satiety and weight loss is suggestive of an obstructive lesion caused by lymphoma or Kaposi's sarcoma. Severe acute abdominal pain can indicate pancreatitis or intestinal perforation due to cytomegalovirus. Right upper quadrant pain (with or without fever, vomiting or abnormal liver function tests with a cholestatic profile) is suggestive of hepatobiliary pathology including cholecystitis, cholangitis, acalculous cholecystitis and AIDS cholangiopathy. Diarrhoea is the most common gastrointestinal symptom of AIDS, affecting 50-90% of patients. Causes of AIDS diarrhoea include protozoa (Cryptosporidium parvum, Isospora belli, Enterocytozoon bieneusi, Septata intestinalis, Cyclospora spp, Entamoeba histolytica and Giardia lamblia), bacteria (Mycobacterium avium-intracellulare, Clostridium difficile, Salmonella, Shigella and Campylobacter jejuni), and viruses (CMV, HSV and possibly HIV). Chronic diarrhoea, malnutrition and weight loss can shorten the life-span of patients with AIDS. Elemental diets, isotonic formulas, medium chain triglycerides and total parenteral nutrition have been tried with little success in AIDS patients with severe diarrhoea and wasting.
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PMID:AIDS and the gut. 805 32

The assessment and diagnosis of abdominal pain in childhood continues to be a clinical challenge. We audited the presenting symptoms and signs in a consecutive series of 447 children presenting to a paediatric surgical unit in an attempt to quantify the value of particular symptoms and signs in differentiating acute appendicitis (AA) from non-specific abdominal pain (NSAP). The onset of pain in the centre of the abdomen and radiation of pain was not sufficient to differentiate between NSAP and AA. Progression of pain, nausea, vomiting, anorexia and diarrhoea were significantly more common in children with AA (P < 0.01). Similarly, facial flushing, tachycardia (pulse > 100 beats/min), guarding and rebound tenderness were significantly more common in children with AA (P < 0.001). Knowledge of this quantitative data could help clinicians adjust the weighting given to the presence of a particular symptom or sign in children with acute abdominal pain.
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PMID:The diagnostic value of symptoms and signs in childhood abdominal pain. 999 Jul 85

Appendicitis is one of the most common causes of acute abdominal pain in the industrialized world. Appendicitis must be considered in the differential diagnosis of any patient presenting with abdominal pain. Workup may include blood tests, abdominal radiographs, abdominal ultrasound, and focused appendix computed tomography. Unfortunately, none of these provides definitive results. Although several signs and symptoms are associated with appendicitis, their inconsistent presentation, especially among the young and the elderly, can lead to an erroneous diagnosis. The classic sequence of symptoms includes the onset of vague epigastric or periumbilical pain; associated nausea, anorexia, or unsustained vomiting; and pain migrating to the right lower quadrant. In uncomplicated cases, the treatment of appendicitis is appendectomy. However, less definitive presentations merit further diagnostic testing and close follow-up.
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PMID:Recognizing the various presentations of appendicitis. 1047 9


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