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)

Ten children (4.6%) among a cohort of 219 with Kawasaki disease (KD) had their onset with severe abdominal complaints. Incomplete KD presentation at the time of acute abdomen was present in nine of 10 patients. Acute abdominal pain and distension, vomiting, hepatomegaly, and jaundice were the most common symptoms at onset. Hematemesis was present in one; toxic shock syndrome requiring care in the intensive care unit occurred in four. Five patients had laparotomy, three had percutaneous transhepatic biliary drainage, and one had a gastrointestinal endoscopy. Postoperative diagnosis was gallbladder hydrops with cholestasis in five, paralytic ileus in three, appendicular vasculitis in one, and hemorrhagic duodenitis in one. All patients completely recovered, but 50% developed coronary aneurysms despite early intravenous gammaglobulin treatment. Acute surgical abdomen can be the presenting manifestation of KD. In older children with fever, rash, and acute abdominal pain or hematemesis, KD should be considered in the differential diagnosis.
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PMID:Acute surgical abdomen as presenting manifestation of Kawasaki disease. 1283 7

We sought to determine the cause of gastrointestinal (GI) intolerance of a ketogenic diet (KD) using an endoscopic investigation, and to examine the relationship between endoscopic lesions and dietary tolerance. Thirty-five patients were enrolled in this study and underwent gastrofiberscopy prior to initiation of the KD. We observed the relationship between abnormal endoscopic findings and prior use of antiepileptic drugs (AEDs) and symptoms of GI disturbance. We treated patients with GI symptoms, and observed whether the KD was subsequently better tolerated. Of the 35 patients enrolled, 20 patients (57%) had abnormal endoscopic findings: ten cases of erosive gastritis, four of duodenitis, three of hemorrhagic gastritis, two of esophagitis, and one case of duodenal ulcer. The incidence of abnormal endoscopic lesions was 78% in the polypharmacy group (14/35) and 81% in steroid consumers (16/35). Symptoms of GI disturbance, such as nausea, vomiting, unusual irritability, cramping abdominal pain, and diet refusal for over a day, were observed in 17 (85%) of those patients with abnormal endoscopic lesions and in five (33%) patients without such lesions. Steroids and polypharmacy with more than three AEDs were factors associated with abnormal endoscopic lesions (p < 0.05). After active management with GI medications, GI symptoms subsided, and in all cases except one, patients were able to continue the KD treatment. In conclusion, symptoms of GI disturbance were frequently associated with abnormal endoscopic findings prior to initiation of the KD. Active management with GI medications increased the tolerability of the KD in patients treated with multiple AEDs and steroids.
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PMID:Improving tolerability of the ketogenic diet in patients with abnormal endoscopic findings. 1822 66

Primary carcinoma of the duodenum is uncommonly encountered. This is a report of a 64-year-old diabetic/hypertensive who was admitted in our unit with six months history of upper abdominal pain, vomiting on and off and weight loss of greater than 10 kgs. Endoscopy revealed complete obstruction of the third part of the duodenum. Lesion biopsy revealed moderately differentiated adenocarcinoma and associated duodenitis. A staging CT scan showed thickening of the duodenal wall over a span of six centimetres, luminal narrowing, mucosal irregularity and multiple para-vascular large nodes some greater than or equal to two centimetres. Palliative bypass surgery was suggested as the preferred mode of treatment. He underwent cholecysto-jejunostomy/jejunojejunostomy to palliate biliary and intestinal obstruction.
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PMID:Primary duodenal cancer: case report. 1825 73

During the period 1983-1993, 166 pediatric patients(91 females and 75 males) were subjected to upper gastrointestinal endoscopy. Epigastric pain or heart burn and vomiting were the indications in 115 (69%) patients. Gastritis. duodenitis, and esophagitis were diagnosed in 63 (38%), and duodenal ulcer in seven (4.2%) patients. Bleeding sites were identified in 10 out of 21 (47.6%) patients with a history of hematemesis. Helicobacter pylori was identified in 12 (48%) of 25 patients with chronic gastritis. Endoscopic removal of foreign bodies (FB) was required in nine patients. Endoscopic small bowel biopsy provided sufficient material to con-firm the diagnosis in seven out of 13 patients with chronic diarrhea. Endoscopic findings were normal in 78 (47%) patients. The procedure was safe and well tolerated.
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PMID:Pattern of pediatric upper gastrointestinal disease: a teaching hospital experience. 1986 37

An 18-year-old man presented with complaints of epigastric pain, vomiting after meals, loss of appetite and weight, evening rise of temperature, and irregular bowel movements. Barium meal follow-through revealed a dilated stomach and first and second parts of the duodenum and stenotic lesion in the second part of the duodenum. Endoscopic biopsy of the stenotic lesion revealed acute on chronic nonspecific duodenitis with fibrosis. Isoperistaltic antecolic gastrojejunostomy was done to bypass the obstruction, and enlarged lymph nodes were biopsied. The biopsy of the enlarged lymph nodes revealed changes consistent with tuberculosis; therefore, the patient was started on antituberculous drugs in the postoperative period.
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PMID:Duodenal stenosis secondary to tuberculosis. 1994 27

Solar burn reactivation, a rare and idiosyncratic drug reaction, has been reported with the use of a variety of drugs. This reaction is believed to be the result of exposure to ultraviolet light during the subsiding phase of an acute inflammatory reaction. It affects areas of the body that have been previously sunburned. We describe a 16-year-old girl who was receiving treatment for acute lymphoblastic leukemia and experienced a second-degree solar burn reactivation reaction to methotrexate. The patient had a mild sunburn on her face and shoulders the day she went to the oncology clinic for her interim maintenance chemotherapy with vincristine 1.5 mg/m(2)/dose and methotrexate 100 mg/m(2)/dose. Three days later, she returned to the clinic with a 2-day history of fever (<or= 100.2 degrees F), nausea, vomiting, and malaise; the sunburn on her face and shoulders also had become severe, without further sun exposure. Laboratory results revealed elevated blood urea nitrogen and serum creatinine concentrations, and her methotrexate level was elevated at 0.9 mM. The patient was diagnosed with acute renal failure, dehydration, methotrexate toxicity, and second-degree solar burn reactivation reaction. She was admitted to the children's hospital and treated with sodium bicarbonate, acetaminophen with codeine, ondansetron, and silvadene cream. On hospital day 3, the patient's methotrexate level decreased to less than 0.1 mM. The sunburn continued to heal, and after a 14-day hospital stay, complicated by a streptococcal infection, grade 3 mucositis, bacteremia, and mild gastritis and duodenitis, the patient recovered and was discharged. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 6) between the patient's solar burn reactivation and methotrexate. Although methotrexate-induced solar burn reactivation is rare, clinicians should be aware of this potential adverse reaction and consider delaying administration of methotrexate by 5-7 days if a patient reports ultraviolet-related erythema in the past 2-4 days or presents with a notable sunburn.
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PMID:Solar burn reactivation induced by methotrexate. 2033 62

A 74-year-old woman was admitted to our hospital with upper abdominal pain and bloody vomiting. An abdominal aneurysm compressed the third portion of the duodenum and the second portion of duodenum was distended with thickened walls as in superior mesenteric artery syndrome. Endoscopic examination showed an edematous mucosa with hemorrhagic erosions, shallow longitudinal ulcers, and star-shaped ulcers in the duodenum. We diagnosed this case as ischemic duodenitis associated with superior mesenteric artery syndrome caused by compression by an abdominal aortic aneurysm. The symptoms improved on treatment with bowel rest, total parenteral nutrition and administration of a proton pump inhibitor. We present here a rare case of ischemic duodenitis and summarize the previous medical literature on the disease.
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PMID:A case of ischemic duodenitis associated with superior mesenteric artery syndrome caused by an abdominal aortic aneurysm. 2188 29

Traditional medicine is widely practiced in tropical countries. Bottle gourd (Lagenaria siceraria) fruit juice is advocated as a part of complementary and alternative medicine. If the bottle gourd juice becomes bitter it is considered toxic. We report 15 patients, who developed toxicity due to drinking bitter bottle gourd juice. Patients presented with abdominal pain, vomiting, hematemesis, diarrhea and hypotension within 15 min to 6-h after ingestion of bottle gourd juice. Endoscopy showed esophagitis, gastric erosions, ulcers and duodenitis. Hypotension was treated with crystalloids and inotropic support. All patients recovered in 1-4 days. Endoscopically the lesions healed in 2 weeks. Bitter bottle gourd can cause gastrointestinal toxicity with hematemesis and hypotension. Supportive management is the treatment and all patients recover within 1 week.
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PMID:Gastrointestinal toxicity due to bitter bottle gourd (Lagenaria siceraria)--a report of 15 cases. 2198 53

Feeding dysfunction (FD) has recently been considered to comprise a prevalent set of symptoms in eosinophilic gastrointestinal disorders (EGIDs) in young children. We report the case of an 8-month-old girl with an EGID who visited our hospital due to vomiting, poor weight gain and feeding difficulties; her condition was discovered during the examination of the symptoms including FD. Tracheal aspiration and reduced esophageal clearance showed up in a barium swallow test and upper gastrointestinal contrast radiography, respectively. Delayed clearance from the stomach was also detected on gastrointestinal scintigraphy. Gastrointestinal endoscopy and biopsies revealed esophagitis with some eosinophils and duodenitis with eosinophilic inflammation. She was not a likely candidate for eosinophilic esophagitis. On administration of an elemental diet, the patient gained weight. Esophageal and stomach clearance subsequently improved, although the vomiting and FD persisted to some extent. We conclude that it is important to consider other EGIDs as well as eosinophilic esophagitis in the differential diagnosis of FD.
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PMID:Eosinophilic gastrointestinal disorder in an infant with feeding dysfunction. 2262 72

A 14-month-old girl presented with the recurring bouts of vomiting and diarrhoea and failure to thrive. At 7 months of age, the baby was found to be exclusively breast fed and her blood tests revealed low calcium, low phosphorous and markedly elevated alkaline phosphatase. She was started on vitamin D and calcium supplements. Five months later, she came in with lower-limb bowing, irritability, vomiting and loose stools. The laboratory studies revealed very low serum hydroxyvitamin D, and high serum dihydroxyvitamin D. Vitamin D dose was doubled. Ten weeks later, her growth velocity had fallen and she continued to have intermittent loose stools. The oesophagogastroduodenoscopy was done and the biopsies showed Helicobacter pylori gastritis and mild duodenitis. After eradication of H pylori, there was a dramatic improvement in her growth and activity and upon 6 months follow- up there was no clinical or radiologic evidence of rickets.
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PMID:A failing to thrive 18 month old with vitamin D deficiency rickets and Helicobacter pylori gastritis. 2268 67


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