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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have studied for periods averaging 111 months 16 survivors out of a series of 20 children treated for oesophageal atresia (EA) by neonatal end-to-end anastomosis. Twelve of them had gastroesophageal reflux (GER) manifested by either digestive (vomiting, dysphagia, pyrosis, haemorrhage or foreign body impaction) or respiratory symptoms (repeated neumoniae or frequent u.r.i.). pH-studies decealed very increased acid exposure in these patients. Manometric studies showed disorganized peristalsis with near-absence of propulsive waves and predominance of mass-contractions. Interestingly both lower esophageal sphincter pressure and length were normal. Five children had histological esophagitis and 2 had Barrett's esophagus. Seven patients have had an anti-reflux procedure and two more should be operated in the near future. Our experience reveals that GER incidence in EA is very high, that esophageal function is severely impaired in this condition, that mucosal lesions can be serious and that funduplication is effective. Since it has been demonstrated that esophageal dysfunction in EA patients is due to structural anomalies, spontaneous improvement should not be expected in them and surgical treatment should be largely indicated. EA patients require long-term gastro-enterologic follow-up.
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PMID:[Motor function of the esophagus following surgery for atresia]. 174 78

The case of a 6.5 years old boy, hospitalised because of recurrent vomiting, epigastrial, periumbilical abdominal pain, is reported. The contrast--medium swallow--x-ray examination showed no alteration, while during repeated continuous 24 hours pH monitoring of the distal esophagus, the pH values permanently were wound to remain under 4. By esophagoscopy, only moderate inflammatory signs could be detected. The long-lasting complaints and the results of pH monitoring indicated serial biopsy from the esophagus-wall. The histological finding showed gastric mucosa 2 cm above the lower esophageal sphincter, i.e. a Barrett syndrome. Upon the treatment administered according to the diagnosis, the complaints of the child considerably improved.
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PMID:[Barrett esophagus in children]. 236 28

In a group of 12 patients with reflux esophagitis resistant to the medical treatment and normal LES pressure, gastric emptying and bile-gastric (B.G.) reflux (HIDA-CCK test) were determined. All of the patients had delayed gastric emptying associated in seven with high levels of B.G. reflux. Two of the patients had an unsuccessful fundoplication two years ago and five have been cured of duodenal 3 or gastric 2 ulcer with antacids. Although there was an evolution to an ulcer scar in all of these patients the abdominal post-prandial pain persisted and some of them maintained occasional bilious vomiting. Deep gastritis with dysplasia and metaplasia of the gastric mucosa was demonstrated in all of these five patients. The esophagitis was an isolated phenomenon in 3 patients, one had a peptic esophageal stricture above de cardia, and another one a Barrett esophagus. A proximal gastric vagotomy (PGV) and pyloroplasty was performed in patients with delayed gastric emptying without BG reflux. The other 7 patients with concomitant high BG reflux were treated by a duodenal diversion to a Roux-en-Y loop and P.G.V. Esophageal and gastric symptoms disappeared soon after surgery. Esophageal biopsies were normal six months after surgery and the intense gastritis changed to a less serious form of superficial gastritis. It is concluded that delayed gastric emptying associated or not with high values of BG reflux can be the most important pathogenic factor that cause reflux esophagitis in this group of patients. The improvement of gastric emptying and elimination of BG reflux can be the proper method to treat these situations.
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PMID:[Surgical therapy of reflux esophagitis in patients with normal lower esophageal sphincter pressure]. 277 77

We assessed the prevalence of Campylobacter pylori in various forms of endoscopic gastritis, including ulcer and nonulcer dyspepsia and bile gastritis and correlated it with histological evidence of inflammation. Multiple biopsy specimens were taken from 120 patients, including four normal controls, who underwent upper gastrointestinal endoscopy for evaluation of upper abdominal pain and discomfort, nausea, bilious vomiting, weight loss, and anemia. The patients included 58 men and 62 women, with a mean age of 53 years. Of these, 16 patients had gastric ulcers, 19 had duodenal ulcers, 26 had reflux gastritis (after either gastric surgery or cholecystectomy), one had a gastric polyp, one had Barrett's esophagus, and the remaining 53 had gastritis due to unspecified causes. Campylobacter-like organisms were demonstrated by light and electron microscopy in 50 of 69 patients of the nonbile gastritis group (72%) and in seven of 15 patients of the bile gastritis group (47%) (p0.05). The presence of bacteria in both groups correlated with histologically significant inflammation (particularly chronic active gastritis); similar histologic changes were noted in both major groups of nonbile gastritis and bile gastritis. Campylobacter pylori is common in all forms of gastritis in association with histologic inflammation.
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PMID:The prevalence of Campylobacter pylori gastritis: a study of symptomatic nonulcer dyspepsia and bile gastritis. 278 19

During the 5-year period from 1981 to 1985, Nissen fundoplication was performed on 13 esophageal atresia patients. One patient with Down's syndrome died because of cardiac malformation 2 weeks after the operation and is excluded from the analysis. Nine of the remaining 12 patients had the usual malformation with distal fistula, while three had isolated atresia. In eight patients there was a long gap between the segments, and in five Livaditis myotomy was necessary. The median age of the patients at the fundoplication was 1.3 years (range, 4.5 months to 10.6 years). The main clinical manifestations were anastomotic stricture (six patients), respiratory complications (three patients), vomiting and difficulties in feeding (two patients), and esophagitis only (one patient). Altogether nine patients had preoperative distal esophagitis. Mean follow-up time was 4.1 years (range, 2.0 to 6.4 years). All patients primarily benefited from the operation. Routine control endoscopy 3 to 8 months after the operation showed a competent fundoplication in all patients. However, in five patients the reflux later recurred, and endoscopy revealed a partially disrupted fundal wrap and esophagitis. Four patients underwent refundoplication and one is waiting for it as of this writing. Four patients had Barrett's esophagus at the last endoscopic control. There was one late death due to cardiac failure. In conclusion, although the short-term results of Nissen fundoplication in esophageal atresia patients are good, the risk for late recurrence is high. Regular long-term follow-up is therefore necessary.
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PMID:Failure of the Nissen fundoplication to control gastroesophageal reflux in esophageal atresia patients. 280 72

Twenty-seven patients from an institution for the developmentally disabled underwent endoscopy for evaluation of vomiting, regurgitation, rumination, or upper gastrointestinal bleeding. The presence of gastroesophageal reflux and Barrett's esophagus was determined retrospectively. Twenty-three patients had an IQ less than 20, 19 were nonambulatory, and 14 were taking at least one neuroleptic drug daily. Seven patients (26%) had histologically documented Barrett's esophagus of the specialized-columnar type. Two patients with Barrett's esophagus had benign esophageal strictures, but no cases of adenocarcinoma were found. There were no significant differences (p greater than 0.05) between patients with or without Barrett's esophagus in regard to symptoms, age, sex, IQ, medications, or ambulatory status. The present data suggest that Barrett's esophagus may frequently occur in developmentally disabled patients with symptoms and signs of gastroesophageal reflux.
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PMID:Gastroesophageal reflux and Barrett's esophagus in developmentally disabled patients. 348 46

A retrospective study was carried out of children undergoing Nissen fundoplication and pyloroplasty for the correction of gastro-oesophageal reflux. Twenty children (thirteen males, seven females) aged 8 months to 12 years underwent surgery over a 10 year period. Forty per cent were mentally retarded. Presentation was failure to thrive in 19 (95 per cent), recurrent vomiting in 18 (90 per cent) and haematemesis in 14 (70 per cent). Four children had Barrett's oesophagus. There were no operative or perioperative mortalities. Follow-up (mean period 3 years, 9 months) revealed no further symptoms of reflux. The 'normal' children gained weight postoperatively whereas the 'retarded' group did not. Adhesion obstruction (10 per cent) was the major late postoperative complication. Regression of Barrett's epithelium was noted endoscopically. 'Gas-bloat' syndrome, a major complication following fundoplication, was not encountered.
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PMID:Nissen fundoplication and pyloroplasty in the management of gastro-oesophageal reflux in children. 360 5

Exophiala jeanselmei was isolated from three esophageal cultures over an 11-month period at Lutheran General Hospital. We believe this provides evidence for a new site of isolation, since previous reports of the organism's incidence were confined to skin and lung. Case 1 is an eight-year-old female with a three-year history of gagging and vomiting. Esophagoscopy revealed a mass biopsied as vegetable material. Case 2 is a 66-year-old retired male with a history of obesity, diabetes and spinal stenosis. Following back surgery, the patient developed odynophagia. Esophageal biopsies showed ulceration and bacterial colonies with no evidence of fungus. Case 3 is a 62-year-old male gardener who is also a nail biter. Esophagoscopy revealed a gastro-esophageal stricture with reflux and evidence of a hiatus hernia. Material biopsied was consistent with Barrett's esophagus and evidence of fungi was seen. The esophageal mass of case 1 and the esophageal brushings of case 2 and 3 grew E. jeanselmei. Aspiration, reflux, and mechanical disruption of the esophageal mucosa are possible predisposing factors in colonization of esophageal lesions by this ubiquitous, normally low virulence organism.
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PMID:Isolation of Exophiala jeanselmei associated with esophageal pathology--three cases, laboratory and clinical features. 649 12

It is widely acknowledged that Barrett's esophagus in adults is an acquired condition resulting from prolonged gastroesophageal reflux. Barrett's esophagus is rare in childhood, even though gastroesophageal reflux occurs commonly in the pediatric age group. When a columnar-lined esophagus is present in children, it is often regarded as a congenital anomaly rather than as a consequence of chronic gastroesophageal reflux. Over a 5-yr period (1978-1982), we retrospectively studied Barrett's esophagus in children 19 yr of age or younger who were evaluated for gastroesophageal reflux and whose symptoms warranted esophagoscopy and esophageal biopsy. Esophageal biopsies were performed on 103 patients with gastroesophageal reflux. Thirteen children (age range, 8 mo-19 yr) had Barrett's esophagus, for a prevalence of 13%. Gastroesophageal reflux was documented in these children by upper gastrointestinal radiographs or pH monitoring. Radiographs demonstrated esophageal stricture in 5 of the 13 children; none had hiatal hernia. Children presented with symptoms suggestive of gastroesophageal reflux and esophagitis: vomiting, abdominal pain, odynophagia, dysphagia, and heartburn. All children had a past history of excessive regurgitation during infancy. Histologically, three types of columnar epithelium were present: gastric fundic type (11 patients), junctional-type columnar epithelium reminiscent of gastric cardia (7 patients), and specialized columnar (metaplastic intestinal) type (2 patients). We believe that Barrett's esophagus is more common in children than had previously been appreciated. In these children, we suggest that the distal columnar-lined esophagus resulted from chronic gastroesophageal reflux and is not a congenital anomaly.
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PMID:Barrett's esophagus in children: a consequence of chronic gastroesophageal reflux. 669 Mar 59

A 4-year-old very debilitated boy, who suffered from recurrent vomiting (regurgitation) since birth, is described. At the age of 18 months, partial obstruction of the esophagus was apparent, and only semisolid food could be swallowed. The signs of obstruction progressed, and the child was admitted urgently, at the age of 4 years, to the authors' department because of severe dehydration. After resuscitation, a barium swallow and esophagoscopy showed a complete obstruction of the esophagus between its middle and lower third. Through a left thoracotomy incision, 4 cm of the diseased esophagus were resected and continually established by end-to-end esophagoesophageal anastomosis. Pathological examination showed complete obstruction of the esophagus with Barrett's epithelium above and below the stricture. Severe periesophagitis was also present because of sealed perforation of the esophagus. One week after the operation the child was on a normal diet. On follow-up, 6 months later, he has no signs of obstruction and is gaining weight. It is postulated that the presence of Barrett's epithelium in the esophagus in congenital, but the complications, such as stricture formation, are usually caused by chronic irritation, such as gastroesophageal reflux. Barrett's epithelium alone infrequently will cause
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PMID:Barrett's epithelium with complete stricture of the esophagus: hypothesis of its etiology. 766 34


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