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Query: UMLS:C0027497 (nausea)
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Three healthy, young adults suddenly experienced the onset of slow gastric emptying. Their symptoms began in February, 1975 in association with a brief illness consistent with a viral gastroenteritis. They complained of early satiety, nausea, and vomiting when they ate solid food and they had lost 11-25 kg in body weight in 8-12 mo. On admission, their physical examinations and laboratory studies were within normal limits. Their stomachs emptied a barium mixture normally, and fiberoptic endoscopy did not detect any abnormalities. The slowed gastric emptying of food was documented with radioisotopic gastric emptying studies. The prolonged emptying rates of 2 patients were reduced 90% with metoclopramide. In association with metoclopramide therapy, the patients were able to eat more food, and they regained 8-10 kg of body weight in 4-6 mo. Their histories raise the possibility that their initial illness may have damaged the mechanisms which control the gastric emptying of food.
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PMID:Sudden onset of slow gastric emptying of food. 45 51

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

In 27 patients after selective or truncal vagotomy and pyloroplasty the occurrence of duodenogastric reflux was checked by two methods, by the measurement of Bromsulphalein (BSP)-concentration in the gastric aspirate after BSP was given intravenously and by instillation of a barium meal in the second part of the duodenum followed by upper GI-series. In 20 of 23 patients reflux was recorded radiologically, in 18 of 27 patients reflux was shown by the BSP-Method. Proven bile reflux was associated with major postoperative discomfort, such as epigastric fullness, nausea and epigastric pain, it was also associated with gastritis as shown by microscopic examination of biopsies taken from the antrum. It is recommended to consider duodenogastric reflux as a possible reason for patients complaints after vagotomy and pyloroplasty. To avoid those complaints the preference of proximal gastric vagotomy without pyloroplasty is supported, if preoperative gastric emptying is not impaired.
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PMID:[Duodenogastric reflux after vagotomy and pyloroplasty (author's transl)]. 125 49

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 case of a rare recurrent lipoma originating from the perirenal fat is reported. Onset of symptoms (abdominal pain, weight loss, appetite loss, abdominal swelling, nausea, constipation) is late and the treatment is surgical, but postoperative radiation or chemotherapy may be indicated. Ultrasound, CT and NMR scans, pyelograms and barium enemas are the most important diagnostic investigations. Follow-up in these patients is important.
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PMID:Recurrent benign retroperitoneal lipoma. 141 Sep 12

Forty Japanese patients with primary malignant tumors of the small intestine were reviewed. Adenocarcinoma was the most common tumor type comprising 19 patients (47%), followed by malignant lymphoma, 11 (30%), leiomyosarcoma, 8 (20%) and carcinoid tumor, 1 (3%). Adenocarcinomas and leiomyosarcomas were primarily located in the duodenum or jejunum, whereas lymphomas were more common in the jejunum or ileum. Abdominal pain (65%) and nausea or vomiting (35%) were the most common symptoms with these tumors. Barium contrast studies were able to detect 83% of these tumors. Our results also suggest that computed tomography and ultrasonography are not reliable for diagnosing jejunal tumors while superior mesenteric angiography is effective for diagnosing ileal tumors. The duodenal and ileal tumors tended to metastasize to lymph nodes while jejunal ones tended to penetrate the serosa or to disseminate into the peritoneal cavity. The percentage of tumors potentially cured by surgery and the 5 year survival rates of the leiomyosarcomas (75% and 57%, respectively) were higher than those of adenocarcinomas (42% and 10%, respectively) and lymphomas (42% and 32%, respectively).
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PMID:Primary malignant tumors of the small intestine: analysis of 40 Japanese patients. 161 34

We compared the effectiveness of 1 mM Geritol, 12% corn oil emulsion, Kaolin-pectin, single contrast oral barium sulfate, and effervescent granules as enteric magnetic resonance imaging (MRI) contrast agents. Five volunteers were recruited. Each volunteer ingested for examinations, separated by at least one week, either 500 ml of each of the liquid preparations or two packets of the CO2 granules (producing 400 ml of CO2 per packet). Abdominal MR images were then obtained using a 1.5 T Magnetom imager and SE 550/22, SE 2000/45/90 and FISP 40/18/40 degrees pulse sequences. The oil emulsions were best tolerated. Barium sulfate caused the greatest amount of nausea, followed by Geritol and Kaolin-pectin. With FISP 40/18/40 degrees, 60%-80% of the small bowel was well delineated using oil emulsion, Kaolin-pectin, or barium sulfate. We conclude that oil emulsion was by far the best enteric MR contrast agent in our study. Good delineation of the small bowel and pancreas can be achieved using oil emulsion and gradient echo pulse sequences. The lack of side-effects and the excellent taste make it highly acceptable to human subjects.
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PMID:Enteric MRI contrast agents: comparative study of five potential agents in humans. 177 27

We report the first case of esophageal liposarcoma in Japan. A 46-year-old female was admitted to our hospital with chief complaint of protruding tumor out of the mouth. She had two episodes of protruding tumor after nausea in last 6 months. Barium swallow showed a large polypoid lesion of approximately 16cm in length with a stalk. By endoscopic examination, it was the polyp originated from the anterior wall of the cervical esophagus. It was covered with intact squamous epithelia, which had slight redness and erosion in the apex. Under general anesthesia the tumor was cut off at the base through the oral cavity. Specimen was 11 x 4 x 3cm in size and had yellowish cut surface. Histologically, the tumor composed of mature adipocytes and many atypical lipoblasts with spider web shaped cytoplasm. We diagnosed this tumor as well differentiated liposarcoma.
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PMID:[A case report of esophageal liposarcoma]. 188

Acute barium salt poisoning may cause acute hypokalemia and result in respiratory paralysis and ventricular tachyarrhythmias. The early nonspecific gastrointestinal symptoms of barium poisoning due to food contamination could be confused with other benign food poisonings. Early diagnosis and initiation of intensive supportive care is essential. We report an outbreak of acute barium carbonate poisoning, occurring at a family reunion party, which resulted in 9 hospital admissions. All of the victims initially developed nausea, vomiting, abdominal colic, dizziness and watery diarrhea followed by numbness of the face and distal extremities 1-2 h after ingesting fried flour-coated sweet potatoes. The flour was later confirmed to be contaminated with barium carbonate. One person died in the emergency room with a serum potassium level of 0.8 mEq/L. Two other victims developed ventricular tachycardia and respiratory paralysis but completely recovered with the treatment advice provided by the poison center. The poison center was successful in helping to make the correct diagnosis in a timely manner, immediately distribute the treatment protocol, and coordinate the laboratory confirmation of barium carbonate poisoning.
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PMID:The essential role of a poison center in handling an outbreak of barium carbonate poisoning. 203 49

Superior mesenteric artery syndrome is a condition in which the third portion of the duodenum is intermittently compressed by the overlying superior mesenteric artery, resulting in gastrointestinal obstruction. Predisposing factors include rapid weight loss, prolonged supine positioning, and using a spinal orthosis, all of which are common among acute traumatic quadriplegic patients. This paper presents three patients, aged 24, 16, and 20 years, with traumatic quadriplegia treated with supine positioning and cervical orthoses, who had postprandial nausea and emesis, bloating, and abdominal pain during rehabilitation. Upper gastrointestinal radiographic series demonstrated abrupt duodenal obstruction to barium flow in all three patients. Two of the patients had complete relief of symptoms with conservative management, and one required surgical duodenojejunostomy. Enhanced awareness of this condition may result in improved recognition of this disease as a cause of persistent, unexplained gastrointestinal disturbances in quadriplegic persons, thereby optimizing its treatment and reducing its potential morbidity.
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PMID:Superior mesenteric artery syndrome in acute traumatic quadriplegia: case reports and literature review. 205 11


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