Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

89 preschool children, 2-4 years old, treated under the diagnosis of appendicitis were analyzed. 46 of them were operated. In 39% of those children the diagnosis of an acute nonperforated appendicitis could have been ensured, in 39% the diagnosis of a perforated appendicitis was found, in 22% the was found, in 22% the laparotomy was negative. In cases of an acute perforated appendicitis typical symptoms were vomiting (100%), general stomach-ache (89%) and fever (61%). In most cases of an perforated appendicitis the state of patients was reduced drastically (80%), in 50% an ileus could be observed. Half a children with an acute nonperforated appendicitis as well as an perforated appendicitis had got a respiratory disease additionally. This fact was the main reason for the to late diagnosis particularly in the age up to 3. In all cases being not sure a consequent control at a ward is necessary; an important fact for this recommendation is the shortness of the acute perforated appendicitis in early childhood.
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PMID:[The diagnosis of appendicitis in childhood]. 175 6

Between 1982 and 1987 550 appendectomies in children under sixteen years of age were carried out in our surgical department. Only 21 patients were children under 4 years of age, accounting for 4% of all patients. The perforation rate however, was 44% in contrast to 12% in older children. One reason is the more difficult, und therefore often delayed, diagnosis. The mean duration of symptoms of appendicitis in young children was 3.4 days. In the special case of perforated appendicitis the mean duration of symptoms was 132 hours, as compared with 42 hours in children without perforation. Clinical examination is decisive for the diagnosis. Fever and vomiting are non-specific symptoms, but frequently present. Some 81% of the patients had leukocytosis over 15,000. If there are any doubts about the indication for appendectomy, x-ray examination should be carried out as a further useful diagnostic procedure.
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PMID:[Appendicitis in early childhood]. 177 32

The retrospective analysis comprised 986 of 1050 patients operated on for acute appendicitis in the period 1983-1987. Appendicitis was most common in the age group from 11 to 20 years. The perforation frequency was 12.4%. Seventy four percent of patients came to the first medical examination with already perforated appendix. The necessary period of observation is the first 12 hours after onset of troubles. Probable presence of phlegmonous appendicitis is small if 48 hours have passed after initiation of troubles. The frequency of the studied symptoms (nausea, vomiting, temperature, leukocytosis) ranged from 49.4% to 64.8%. The most common postoperative complication is wound infection. The overall mortality rate was 0.1%.
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PMID:[Age distribution and clinical characteristics in acute appendicitis]. 189 69

We report a rare case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation. The case was a 27-year-old male who underwent ventriculoperitoneal (V-P) shunt on the right side for hydrocephalus caused by traumatic intracerebral and intraventricular hemorrhage. One month later, he became somnolent with posterior fossa symptoms (nausea, vomiting and nystagmus). CT scan demonstrated enlarged fourth ventricle, which was diagnosed as DLCFV because the ventriculogram revealed patency of the aqueduct. One and half month later a second V-P shunt was made on the left side to increase the shunt flow. He became ambulatory with a cane, although the fourth ventricle remained moderately dilated on CT scan. Two months after the additional V-P shunt, he slipped and hit the occiput and immediately became tetraparetic. The patient was treated conservatively under the diagnosis of central spinal cord injury. The MRI taken 2 months after the accident revealed Chiari malformation (type 1), syringomyelia and a dilated fourth ventricle which was compressing the brainstem. After the fourth ventriculoperitoneal (FV-P) shunt, the tetraparesis transiently improved but then again worsened. On the CT scan the syrinx did non change in size, while the size of the fourth ventricle became normal. After syringoperitoneal (S-P) shunt the patient showed a moderate improvement of tetraparesis. Unfortunately he suffered appendicitis complicated with peritonitis and all the shunts were immediately changed to external drainage. However, the patient developed meningitis and became paraplegic. The motor function of the upper extremities slightly improved by aspiration of fluid via the external drainage system from the syrinx.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation]. 202 74

Anisakiasis is a zoonotic disease caused by the ingestion of larval nematodes in raw seafood dishes such as sushi, sashimi, ceviche, and pickled herring. Symptoms of anisakiasis include abdominal pain, nausea, vomiting, and diarrhea. Because symptoms are vague, this disease is often misdiagnosed as appendicitis, acute abdomen, stomach ulcers, or ileitis. Endoscopic examination with biopsy forceps has facilitated the diagnosis of gastric anisakiasis. Worms can be removed and identified, and a definitive diagnosis can be made. Patients generally recover with no further evidence of disease. Worms can become invasive, however, and migrate beyond the stomach, penetrating the intestine, omentum, liver, pancreas, and probably the lungs. Surgery is often necessary for treatment of invasive anisakiasis. With the increase in popularity of eating lightly cooked or raw fish dishes, the number of cases of anisakiasis may be expected to increase.
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PMID:Anisakiasis. 267 Jan 91

In order to establish a guide for the diagnosis of acute appendicitis, we reviewed the charts of patients with appendectomy. In a 7-year period, 385 patients were studied. The age range was 3 to 15 years. In 53% there was an administration of medications prior to surgery. Perforated appendicitis was found in the majority (53%) of the cases. We could not find any association between age and perforation. Only localized, persistent abdominal pain, peritoneal irritation, anorexia, and vomiting were useful for differential diagnosis. In patients with acute appendicitis (p greater than 0.05), leukocytosis (greater than 10,000/mm3), neutrophilia (greater than 70%) and bands (greater than 3%) were observed in 80% of the cases. The frequency of complications was elevated (39.5%), and the mortality was five times higher than referred in other studies. We propose an algorithm for both opportune diagnosis and treatment of the disease.
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PMID:[Acute appendicitis in children. Experience at a general hospital]. 271 47

Adnexal torsion is rare in children and is usually reported as small series or case reports. We reviewed a series of 19 consecutive cases of children aged 3 to 19 years (mean, 9.6 years) who were treated in our institution between 1977 and 1988. Thirteen patients presented with torsion of a previously normal adnexa, while six presented with torsion of a diseased adnexa. The right adnexa was involved in 84% of cases. Detorsion with recovery of vascularization of the adnexa was possible in only four cases. All patients presented with lower abdominal pain, and onset was sudden in 78% of cases with an average of 5.2 days between the first symptom and hospital admission and a mean delay of 30.2 hours between consultation and surgical intervention. A previous history of abdominal pain was present in nine cases. Nausea or vomiting were present in 84% of cases. An abdominal mass was palpable in 42% of the patients and was associated with a delay in surgical intervention. Ultrasound confirmed the presence of a mass in 94% of cases. The preoperative diagnosis was accurate in 37% of cases, and the most common inaccurate diagnosis was appendicitis or appendiceal abcess. Our series confirms the predominance of right-sided lesions as reported in the literature. It is not clear whether this is an anatomic phenomenon or whether the suspicion of appendicitis leads to the more frequent diagnosis of right-sided lesions, whereas many left-sided adnexal torsions are being missed. We therefore advocate pelvic ultrasound in female patients who present with left lower quadrant pain.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Adnexal torsion in children. 280 69

Methylphenidate (MPT) was prescribed four days after an uncomplicated appendectomy in a 27 year old woman who had suffered from bulimia nervosa (BN) for at least nine years. Before the onset of appendicitis, her bingeing and self-induced vomiting had occurred several times daily. With MPT the patient reported a calm emotional state and an absence of temptation to binge or to induce vomiting. Previously published reports of treatment of BN with MPT could not be found. This may be the first. Vulnerability to surgical disorders and to postoperative complications as well as the safety and efficacy of MPT in patients suffering from BN deserve further study.
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PMID:Methylphenidate treatment of bulimia nervosa after surgery. 281 49

Diagnosis of the cause of lower abdominal pain in women may be difficult because appendicitis and pelvic inflammatory disease often present similarly. In a prospective study of 118 women, we found that several criteria are useful in establishing this differential. These include (1) duration of symptoms, (2) the presence of nausea, vomiting or both, (3) a history of venereal disease, (4) cervical motion tenderness, (5) adnexal tenderness, and (6) isolated peritoneal signs in the right lower quadrant. Although no single finding can define the diagnosis, the history and physical findings reported herein provide a number of criteria which, when taken together, will usually allow a confident diagnosis of either appendicitis or pelvic inflammatory disease to be made. Attention to these items can improve precision in diagnosis and lessen the incidence of unnecessary laparotomy, which carries a well-documented complication rate of 10 to 20 percent.
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PMID:Differential diagnosis of appendicitis and pelvic inflammatory disease. A prospective analysis. 316 Feb 52

Differentiating acute appendicitis from other causes of acute abdominal pain in children frequently remains unsatisfactory. To determine whether initial historical and physical examination findings might predict final diagnoses, 246 patients with complaints of nontraumatic and nonrecurrent acute abdominal pain were studied. All were between three and 18 years of age and had presented to a hospital-based pediatric emergency department. Each family was telephoned an average of 5.1 days after the visit to determine the patient's subsequent clinical course; operative notes and pathology reports were reviewed for patients receiving surgery. Of these patients with acute abdominal pain, both fever and vomiting were present in 18 of the 24 who eventually had diagnoses of appendicitis, compared with 49 of 222 patients with other final diagnoses (P less than 0.01, with negative predictive value 0.97, sensitivity 0.75, and specificity 0.78, but positive predictive value only 0.27). The duration of the pain at presentation and the frequency of other symptoms (eg, diarrhea, dysuria, anorexia, and lethargy) were unrelated, however, to final diagnosis, as was the duration of the pain and whether abdominal tenderness initially was localized or generalized. Nonruptured appendicitis was generally indistinguishable from ruptured appendicitis preoperatively, by both duration and symptoms. Boys were found more likely to have appendicitis (with or without rupture) than girls (18/118 or 15%, vs. 6/128 or 5%, P less than 0.05). In conclusion, fever and vomiting were noted at presentation more frequently in children with appendicitis than in children with other causes of acute abdominal pain.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnosing appendicitis in children with acute abdominal pain. 318 19


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