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

An important number of cholecystectomized patients after some years of complete well-being, begin complaining of symptoms such as periodic diarrhea or constipation, abdominal pain, regurgitation, vomiting, etc. The purpose of this study is to try to identify an alteration or lesion in the stomach or colon in cholecystectomized patients of more than five years standing, which may be causing the aforementioned condition. The forty patients under observation, free of biliary tract post-operative lesions, were subjected to: hemogram, amylasemia, either infusion cholangiograph or ERCP, fecal parasitological-tests, upper digestive and colon X Ray series, esophagus, stomach and duodenal endoscopy with biopsies. Additionally, ten underwent a colonoscopy which also included biopsy. The result of the radiological, amylasemia and hemogram studies was normal in all cases. The parasitological tests were negative. In every case, a moderate to severe superficial, chronic gastritis was found as well as minor histopathological alterations in the colon mucosa. The presence of bile in both duodenum and colon in interdigestive periods, alterations in the enterohepatic circulation as well as in the biliary composition itself, are suggested as the possible causes of the patients symptoms.
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PMID:[Digestive changes in cholecystectomized patients]. 718 35

Acid corrosive gastritis is infrequently seen. It spares the esophagus and damages the antrum. It causes mucosal ulceration, damages the muscularis and ends in a typical antral stricture. The dynamic perpetuating pathophysiologic events, starting with coagulation necrosis, impose postponement of surgical intervention. Two cases of second degree acid corrosive gastritis are presented. Surgery was performed in both patients, only after dysphagia and vomiting became intractable.
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PMID:Acid corrosive gastritis. A plea for delayed surgical approach. 721 88

Alkaline reflex gastritis is a disabling clinical syndrome, occurring most often after gastric surgery. It is characterized by abdominal pain and bilious vomiting, and, presumably, is due to gastric irritation by regurgitated duodenal contents. The only known effective treatment is by surgical diversion to prevent the duodenal reflux. Unfortunately, the clinical diagnosis is difficult to prove, and the results of surgery are too often disappointing because of inaccurate patient selection. This is a report of a new test for distinguishing patients with symptomatic bile reflux gastritis. The test consists of blind sequential infusion into the stomach, via nasogastric tube, of 20 ml of 0.1 N HCl, normal saline, 0.1 N NaOH, and the patient's own gastric contents. Each solution is given twice. A positive test is defined as reproduction of the patient's usual pain by NaOH, and/or gastric contents, but not by acid or saline. Fifteen of 21 patients with clinical symptoms and endoscopic findings suggesting bile gastritis had a positive alkali infusion test, while only one of 18 normal controls and none of 17 controls with other causes of abdominal pain had a positive test (p less than 0.001). Of the 21 patients with clinical-endoscopic bile gastritis, 15 have had surgical treatment by Roux-en-Y gastrojejunostomy. Nine of ten patients with positive test had excellent symptomatic relief after surgery. Zero of five patients with a negative test were relieved of pain after the operation. Tis simple test appears to be a sensitive, specific, and accurate means for selecting patients for surgical treatment of alkaline reflux gastritis.
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PMID:Intragastric alkali infusion: a simple, accurate provocative test for diagnosis of symptomatic alkaline reflux gastritis. 727 47

Seventy-five patients with unsatisfactory results following vagotomy, drainage and cholecystectomy have been reviewed. The operations were performed together in 45 patients, vagotomy preceded cholecystectomy in 16 patients and cholecystectomy was performed before vagotomy in 14 patients. The interval between the two operations when cholecystectomy was performed first was 7.1 +/- 1.66 SE years, whereas when vagotomy was performed first this was 3.1 +/- 1.03 SE years (p less than 0.05). Forty-three patients had symptomatic bile reflux gastritis and 59 had postvagotomy diarrhea. Dumping, bilious vomiting and recurrent peptic ulceration occurred in 11 patients, nine and five patients, respectively, and were no more frequently encountered than would have been expected after vagotomy and drainage alone. In the light of the information derived from the addition of cholecystectomy to vagotomy and drainage a pathophysiology of postvagotomy diarrhea without dumping, and bile reflux gastritis without bilious vomiting or recurrent chronic peptic ulceration is postulated.
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PMID:Postvagotomy and cholecystectomy syndrome. 729 32

Radiological and endoscopic shrinkage of the antrum of the stomach may occur in the elderly and following gastroenterostomy. We describe this in 18 subjects, of whom 17 had a gastroenterostomy with or without vagotomy. Shrinkage can appear within two years of operation and is usually associated with a well-functioning stoma. Reflux biliary gastritis occurred in almost all and in nine out of ten tested the acid secretion in response to pentagastrin was virtually nil. Dyspepsia and bile vomiting were frequent indications for endoscopy. No patient had jejunal ulceration. In the majority radiological interpretation was correct.
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PMID:Shrinkage of the gastric antrum following gastroenterostomy. 731 80

The results of Roux-Y reconstruction in 46 patients diagnosed as having alkaline reflux gastritis were analyzed to determine which factors in the preoperative evaluation were associated with a good clinical result after surgery. The operation was considered successful in 30 (65 percent) of the 46 patients. Success was not related to the details of the patient's symptoms, the visible appearance of the gastric mucosa at endoscopy or the extent of histologic abnormalities in a preoperative biopsy or resected specimen of gastric mucosa. Therefore, the outcome of surgery could not be predicted from preoperative findings, and gastritis, even though it is often present, is not likely to be responsible for the symptoms in this syndrome. Nevertheless, the results of surgery for postgastrectomy bile vomiting and abdominal pain are good enough that when other conditions have been ruled out, Roux-Y reconstruction can be recommended for patients with severe complaints.
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PMID:Alkaline reflux gastritis: a reevaluation. 739 85

The hypothesis that reflux of upper intestinal content, particularly of bile acids (BA), is responsible for a unique postgastrectomy syndrome, alkaline reflux gastritis, was tested on 28 occasions in 21 postoperative patients (14 symptomatic patients, 7 controls). Parameters evaluated: recumbent (rec.), upright, p.c. intragastric pH, {BA}, net BA reflux per hour, specific BA fractions, fasting and p.c. gastrin, maximal acid output (MAO), gastric emptying of solids by delta-scintigraphy), and the severity of nonstomal histologic gastritis, the "gastritis score," graded 0-15 by an independent senior pathologist. For the entire group, gastritis severity correlated positively with intragastric {BA} and net BA reflux per hour, both in recumbency and p.c. Five symptomatic patients demonstrated rec. and p.c. {BA} and net BA reflux per hour greater than two standard deviations from comparable mean values in control patients. They differed significantly from the remaining symptomatic patients as follows: increased intragastric {BA} and net BA reflux per hour, increased intragastric pH and decreased MAO. They also demonstrated a more severe grade of gastritis. Lithocholic acid was present in their reflux content significantly more often. Bilious vomiting was also more frequent. No other differences could be identified, either objectively or clinically, between the symptomatic groups. Four patients with excessive reflux underwent Roux-en-Y revision and restudy 6-22 months later. BA reflux was completely abolished, histologic gastritis improved, hematocrit rose, MAO increased, and gastric emptying slowed. Burning pain, bilious vomiting, and symptoms of esophageal reflux were eliminated. Vomiting and nausea were improved. Diarrhea was unchanged. The objective criteria outlined can identify symptomatic postgastrectomy patients with a greater than normal reflux and gastritis. Clinical criteria alone cannot. Revisional surgery in these patients eliminates reflux, improves gastritis, and produces symptomatic improvement. The hypothesis under consideration is strengthened but not proven.
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PMID:Alkaline reflux gastritis. An objective assessment of its diagnosis and treatment. 741 26

Residual gastritis after gastrectomy brings the various symptoms such as abdominal pain, nausea, emesis and loss of appetite, and often hazards quality of life of the patient. Bile reflux to the stomach is believed as one of the important pathogenesis of residual gastritis, however the prevention for bile reflux cannot always heal the gastritis. Helicobacter pylori (H. pylori) is considered as one of the most important pathogenesis of gastroduodenal ulcer and gastritis, and H. pylori may possibly cause residual gastritis after gastrectomy. However, the association between infection with H. pylori and the residual gastritis has not revealed yet. In the present study, the association with H. pylori and the residual gastritis after gastrectomy was investigated in 56 patients who had undergone gastrectomy before. Twenty-four patients (42.9%) had H. pylori infection at their stomachs and the incidence of the infection in the patients with gastrectomy was significantly higher with subtotal gastrectomy. As for the histological gastritis score of Rauws (Rauws' score), Rauws' score of H. pylori positive group was significantly higher than H. pylori negative group. Furthermore, the eradication of H. pylori for the patients with serious symptoms of gastritis improved the symptoms and decreased significantly Rauws' score. These results suggest that H. pylori was associated with the pathogenesis of residual gastritis after gastrectomy.
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PMID:[Residual gastritis after gastrectomy and Helicobacter pylori--its clinical significance]. 778 78

We evaluated in children with abdominal complaints the prevalence of Helicobacter pylori gastric and duodenal colonization and the histological features of gastric and duodenal mucosae. Fifty patients, aged 1-17 years, underwent upper endoscopy for recurrent abdominal pain, vomiting and/or gastrointestinal bleeding. With serological, bacteriological and/or histological methods twenty-eight children were demonstrated to be Helicobacter pylori-positive. No statistically significant differences were observed with regard to age, sex and indication to perform endoscopy. Eighty-two percent of Helicobacter pylori-positive patients had gastritis and/or duodenitis. The Helicobacter pylori-positive children had higher Helicobacter pylori specific IgG levels than the Helicobacter pylori-negative ones (p < 0.001). No statistically significant differences were found between Helicobacter pylori-positive and Helicobacter pylori-negative subjects, for gastrin and pepsinogen I. Since the frequency of Helicobacter pylori infection in children with gastrointestinal complaints is high, in patients undergoing upper endoscopy, the sistematical examination of bioptic samples for bacteriological and histologic procedures is of great importance.
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PMID:[High incidence of Helicobacter pylori infections in an endoscopic pediatric patient series]. 780 63

Helicobacter pylori is an established cause of chronic-active gastritis in both adults and children. However, it is unclear whether H. pylori causes specific clinical symptoms. Therefore, the spectrum of clinical symptoms associated with H. pylori infection was studied in consecutive symptomatic children undergoing diagnostic endoscopy at two pediatric centers, using a structured questionnaire. In Toronto, Canada, 86 of 97 eligible children were enrolled into the study and in Limerick, Ireland, 24 of 29 were enrolled. The frequency of biopsy-confirmed H. pylori infection in Limerick, 16 of 24 (67%), was fivefold higher than in Toronto, 11 of 86 (13%, P = 0.0001). The two study populations were comparable in clinical presentation and duration of symptomatology and did not differ in age (11.9 +/- 3.5 and 11.6 +/- 2.0 years, respectively). Within both study populations H. pylori infection was not associated with specific clinical symptomatology, including duration of abdominal pain, location of pain, and history of melena or vomiting. H. pylori was positively associated with hematemesis in the Limerick group. These findings demonstrate that H. pylori infection in children is not associated with specific clinical symptomatology across varying geographical locations.
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PMID:Helicobacter pylori infection in children. Is there specific symptomatology? 802 61


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