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

The authors describe a truly uncommon case of internal abdominal hernia attributable to malformation of the falciform ligament. The patient, a man aged 26, had complained in the past of cramping pain in the epigastric region, usually occurring after meals and sometimes ending with vomiting of ingested food; but all diagnostic methods and procedures had consistently ruled out any extant pathology of the stomach, duodenum, biliary tract, or pancreas. Present hospitalization was justified by a clinical picture suggesting peritonitis from perforated gastric or duodenal ulcer. At operation the authors found a strangulated loop of small intestine following left-to-right migration through a hole in the falciform ligament of the liver. In the authors' interpretation the background cause of the trouble was incomplete development of the falciform ligament, and the immediate cause of the acute episode was abnormal motility and exaggerated peristalsis of the ileum, possibly due to the presence of a diverticulum; the latter two conditions are invoked as a possible explanation for the repeated episodes of abdominal pain in the patient's history.
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PMID:[Internal abdominal hernia caused by anomaly of the falciform ligament (a case report)]. 55 70

A long-term prospective follow-up of 113 children with vomiting due to a small hiatal hernia is described. When reviewed by the same clinical and radiological observers 20 or more years later, over 90% of unoperated non-stricture patients were asymptomatic whereas only 44% of the stricture and/or surgically treated group were without symptoms. Half or possibly more of the asymptomatic patients still had a hernia and it is possible that these may suffer a recurrence of symptoms later in adult life. The loculus of thoracic stomach tended to retain the same shape; there was a slightly better prognosis for the locular type of hernia compared with the tubular type. Complicating oesophageal strictures can decrease or disappear without surgery other than dilatation; the results of treatment by radical surgery were disappointing. There is need for an even more prolonged follow-up into later adult life.
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PMID:A 20-year prospective follow-up of childhood hiatal hernia. 87 83

From an extensive review of the published cases of lesions of the esophagus and stomach brought about by vomiting and a supplemental review of local experience with the Mallory-Weiss syndrome, the influence of hiatus hernia on the lesion site can now be defined. Mallory-Weiss lesions located in the gastric cardia are commonly associated with hiatus hernia. By contrast, those occurring in the distal esophagus and those that overlie the cardioesophageal junction are only rarely associated with hernia. The Boerhaave lesion occurs most probably in the absence of hiatus hernia and in 2 of 3 previously reported cases wherein a hernia was present, a combined gastroesophageal rupture occurred. A newly recognized postemetic form of gastric rupture is clearly distinguished from other causes of this lesion and its characteristic location is described. A unifying hypothesis is proposed in which the location of lesions occurring during emesis is determined by the presence of a hiatus hernia during retching.
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PMID:Lesions brought on by vomiting: the effect of hiatus hernia of the site of injury. 95 56

In some patients with hiatus hernia, vomiting may propel a plug of redundant gastric mucosa into the distal esophagus, where it becomes incarcerated and engorged. Significant bleeding may result. Reduction of the hernia controls the hemorrhage. Endoscopy after the acute episode may demonstrate a gastric mucosal lesion considered to be characteristic of the syndrome.
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PMID:Acute hemorrhagic incarceration of prolapsed gastric mucosa. 108 30

A 3-week-old boy presented with repeated episodes of vomiting and constipation. At laparotomy a jejunal diverticulum arising from its antimesenteric border and extending retroperitoneally was found. The narrow neck of diverticulum caused a situation similar to a Richter's hernia. The fundus of diverticulum was attached to the upper pole of left kidney. A retroperitoneal jejunal diverticulum is a new addition to the cause of neonatal intestinal obstruction.
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PMID:Retroperitoneal jejunal diverticulum: cause of intestinal obstruction. 146 85

Intestinal malrotation may be complicated by volvulus and intestinal necrosis. One hundred two children (64 male, 38 female) undergoing surgical abdominal exploration from 1977 to 1987 had malrotation. Fifty-two patients were less than 7 days of age, 13 from 8 to 30 days, 26 from 31 to 365 days, and 11 were older than 1 year of age. Of infants, 39 of 65 had 40-week gestations, 18 of 65 had 36- to 39-week gestations, and 8 of 65 had less than 36-week gestations. Chief symptomatology included: bilious emesis (47), intestinal obstruction (19), abdominal pain (11), and bloody stools (7). Seventy patients had congenital anomalies (50 single, 20 multiple). Diagnostic evaluations included 56 upper gastrointestinal series and 27 barium enemas. Each patient underwent correction of malrotation and appendectomy, and correction of congenital anomalies (omphalocele-9, gastroschisis-6, diaphragmatic hernia-7). Complications included short gut (2), sepsis (5), feeding difficulties (2), pneumonia (3), small bowel obstruction (2), and other (15). Nine patients (8.8%) died (trisomy 18-1, trisomy 13-1, intestinal necrosis-3, hepatic failure-1, prematurity-1, other sepsis-2). Two hundred sixteen children with intestinal malrotation have been treated from 1937 to 1987. Mortality rate has improved from 23% to 2.9%.
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PMID:Malrotation of the intestine in children. 154 4

Primary appendicitis presenting in a hernia sac is uncommon. Diagnosis depends on a high index of suspicion. The authors present a case report of a 65-year-old male with a two-day history of a painful irreducible right inguinal mass; he denied abdominal pain, nausea, vomiting, fever, or chills.
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PMID:Case report: acute appendicitis in an inguinal hernia. 157 5

Congenital diaphragmatic hernia (CDH) is a common cause of severe respiratory distress in the newborn. However, the presentation of CDH in older children and adults is rare, and, therefore, little is known concerning its symptoms, operative management, and postoperative complications. Thirteen patients (age range: 2 months to 26 years; 5 males, 8 females) presented with CDH. Four patients had right-sided hernias, eight left-sided hernias, and one bilateral hernias. Symptoms included chronic respiratory tract infections in 6 patients, vomiting in 5, weight loss in 1, severe failure to thrive in 2, and severe respiratory distress in 3; one patient was asymptomatic. Physical signs included the absence of breathing sounds or bowel sounds in the chest in eight patients, hyperresonance in one, and cachexia in two. The diagnosis was confirmed in each patient by chest roentgenogram or gastrointestinal contrast radiograph. All patients underwent immediate repair. After reduction of the viscera, 12 of 13 patients underwent primary diaphragm repair, whereas one patient required a prosthetic diaphragm patch. Twelve of 13 patients (92%) survived. Postoperatively, 7 of the 12 survivors (58%) developed severe gastric atony, and four required further operative therapy. In contrast to newborns, CDH in the older child and adult is frequently seen on the right side, rarely presents with severe respiratory distress, and is occasionally asymptomatic. Postoperative gastric atony is a major cause of morbidity, making transabdominal repair with simultaneous pyloroplasty and/or feeding jejunostomy the preferred operative approach.
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PMID:Congenital diaphragmatic hernia beyond infancy. 167 Feb 42

From a total of 2,146 oesophagojejunal and gastrojejunal anastomoses done between 1969 and June 1990, 7 patients (0.3%) were operated on for internal hernias. Six had developed their hernias after Billroth II gastrectomy with antecolic gastrojejunostomy and enteroanastomosis, and one patient after retrocolic Roux-en-Y reconstruction. The patients were operated on 5 days-27 years after their first operations. No patients developed internal hernias after simple gastrojejunostomy or after operations for malignant disease. Two patients died (29%) and three others developed complications. Five patients were thin. Treatment was delayed in most cases because of the nonspecific presentation of the condition. The diagnosis of internal hernia should be borne in mind in patients who develop abdominal pain with persistent nausea or vomiting after operation, so that prompt treatment may be instituted.
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PMID:Internal hernias after gastric operations. 168 46

The intestinal post-operative bridle represents the third most important etiology of obstructions at the clinic of the University Hospital of Dakar, behind hernia strangulations and the volvulus of the digestive tube. Between 1970 and 1989, a retrospective study has led to a sample of 79 patients with post-operative bridle obstructions. The group was made of 47 women and 32 men between 17 and 84 years of age. Stomach ache was by far the most common functional symptomatology, followed by the stoppage of the transit and vomiting. In most cases palpation revealed the presence of tympanism. For almost all the patients, the abdomen without preparation revealed either a hydroaeric level or a diffuse grey area. The initial intervention concerned mainly gynecological affections or pathologies of appendicular type. The resection of the bridles was carried out in most cases. There were 10 deaths. The intestinal obstructions by post-operative bridles continue to be a surgical emergency still characterized by a high mortality rate. The late consultation of the patients, often received when presenting considerable visceral deficiency, is one of the main causes of the high rate of fatalities.
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PMID:[Intestinal obstruction caused by postoperative adhesion. 79 cases]. 180 62


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