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

The hallmark of intestinal obstruction, whether due to a mechanical cause or to absence of peristalsis, is the intraluminal accumulation of fluid. The presence of air simply makes it easier to visualize dilated fluid-filled loops of plain radiographs. When gas is absent, secondary to vomiting or to cessation of air swallowing, the fluid-filled loops may be difficult to identify. In closed loop obstruction, air cannot enter the involved bowel, and in this situation sonography may provide important information concerning the status of the intestinal tract. In nonstrangulating obstruction, sonography offers confirmatory evidence of dilated fluid-filled loops of bowel. In some instances, ultrasonography may correctly identify the gastrointestinal tract origin of a problem thus enabling appropriate management of the patient. We describe three patients in whom ultrasound enabled prompt diagnosis of fluid-filled loops.
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PMID:Diagnosis of small bowel obstruction: the contribution of diagnostic ultrasound. 11 13

There is a high incidence of primary colonic intussusceptions in infants and children in Africa. The case histories of 37 patients are reviewed. Of the varieties described, the caecocolic intussusception (16 patients) presents as an intestinal upset, often mild, with symptoms of colic and vomiting. In many of these patients there is known to be an intestinal infestation with Ascaris lumbricoides. This often leads to a delay in establishing the correct diagnosis. Colocolic intussusception (13 patients) gives rise to more acute abdominal symptoms. On clinical assessment, signs of intestinal obstruction are found and there is usually an intra-abdominal mass which can be palpated in the left colon. Further confirmatory evidence of intussusception is the finding of occult blood in stools. There is an unusually high incidence of sigmoid intussusceptions in infants (8 patients). The diagnosis of this form of intussusception is often delayed owing to inadequate clinical assessment of prolapsed bowel at the anal orifice. The length of the prolapsed bowel, the curved nature of the prolapse and the possible demonstration of a sulcus between the prolapsed bowel and the anal canal wall, aid in diagnosis.
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PMID:Colonic intussusceptions in children. 36 78

Gastrointestinal metastases secondary to bronchogenic carcinoma are relatively uncommon and most are found incidentally at autopsy examination in patients with advanced or widely disseminated lung cancer. Occasionally gastrointestinal metastases occurr relatively early in the course of the disease and give rise to a variety of clinical symptoms and radiological abnormalities. Recognition of these abnormalities is important in order that appropriate palliative therapy may be undertaken. The clinical. radiological and pathological findings in 12 patients with symptomatic gastrointestinal metastases secondary to bronchogenic carcinoma were reviewed. Clinical symptoms varied according to the site of metastatic involvement and included dysphagia, epigastric pain, nausea, vomiting, gastrointestinal bleeding, anaemia and signs of intestinal obstruction or perforation. The sites of metastatic involvement were: oesphagogastric junction (2 cases); stomach (2 cases); duodenum (1 case): jejunum (3 cases); ileum (2 cases), colon (2 cases). The radiological findings are discussed and illustrated.
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PMID:Symptomatic gastrointestinal metastases secondary to bronchogenic carcinoma. 63 63

Perforated appendix in the newborn period is rare, its symptoms are occult and its outcome is disastrous. Associated mechanical small bowel obstruction as part of the clinical picture is rare indeed. We have treated a premature infant who presented with prolonged intermittent vomiting. Factors contributing to difficulty in diagnosis and to eventual succussful management are discussed.
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PMID:Intestinal obstruction from appendiceal abscess in a newborn infant. 65 Mar 68

The treatment of thirty-one malignant and eleven benign neoplasms of the small intestine is reported. The most common symptom was abdominal pain followed by vomiting, diarrhea, weight loss, constipation, and gastrointestinal bleeding. In four cases small bowel perforated. Intestinal obstruction occurred in 31 per cent of patients. Preoperative diagnosis was made in 19 per cent of patients. All eleven patients with benign neoplasms were curatively treated by resection and primary anastomosis. Eighteen of the thirty-one patients with malignant tumors had curative resection, five had palliative resection, and eight had laparotomy and biopsy only. The most common benign tumor was leiomyoma. The most common malignant tumor was lymphoma (67 per cent) followed by adenocarcinoma (16 per cent), carcinoid (10 per cent), and leiomyosarcoma (3 per cent). Twenty-four patients were available for follow up; thirteen remain alive and eleven died, seven within one year and four within two years.
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PMID:Primary neoplasms of the small bowel. 66 96

The so-called superior-mesenteric-artery syndrome is not mentioned in psychiatric journals or books. Yet two variations of the condition have been described. In its acute form, it can be mistaken for psychogenic vomiting in anorexic patients, while its chronic intermittent form is readily misdiagnosed as anorexia nervosa. The case report is of a 16 year old boy admitted for investigation and treatment of severe weight loss. He initially responded to a modified behaviour program, but within days developed an acute small-bowel obstruction. Superior-mesenteric-artery syndrome was diagnosed and he improved with appropriate medical management. This condition needs to be considered by the psychiatrist who otherwise might not differentiate it from the symptoms of anorexia nervosa.
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PMID:The superior-mesenteric-artery syndrome: cause or complication of anorexia nervosa? 67 42

An illness characterized by recurrent episodes of small bowel obstruction is described. The patient, a 79-year old gentleman has been followed for 20 years. During this time he has hospitalized 19 times. Extensive investigation, including three exploratory laparotomies, have failed to show a cause of the bowel dysfunction. The clinical findings have been similar on each admission. Cramping abdominal pain, vomiting, obstipation often followed by diarrhea, tender distended abdomen, high pitched bowel sounds and abdominal x-rays revealed dilatation of small and large intestine and delayed gastric emptying on various admissions. The failure to demonstrate a recognized etiology for the repeated bowel obstruction over a long period of time warrants a clinical diagnosis of chronic idiopathic intestinal pseudo-obstruction (C.I.I.P.). The age of the patient at the onset of symptoms and the duration of the dysfunction prompted a review of the literature. Twenty-seven reported cases allowed a comparison of this case with the clinical features previously described. Symptomatic therapy, consisting of small bowel decompression by intestinal intubation during the acute episode, was followed by the use of elemental diets given slowly and continuously during the convalescing period. The patient continues to be comfortable and able to maintain his body weight between episodes which, however, seem to be increasing in frequency.
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PMID:Chronic idiopathic pseudo-obstructive bowel disease. 71 82

Out of series of 237 colonic aganglionisms (1965--1977) 32 cases (13%) showed a clincial, radiological and manometric syndrome of "incompetent ileocaecal valve". Symptoms were vomiting, constipation with bouts of diarrhea, incomplete intestinal obstruction and failure to thrive. Sixteen cases were under P-3 weight percentiles. Initial diagnosis were aganglionism (10 cases), hiatal hernia (4 cases) and N.E.C. (1 case). Seventeen patients were explored through an iliac incision in the first three months of life. Ileocaecal continence was minimal (less than 25 cm. of water pressure). Ilocaecoplication was performed and completed with internal sphincterectomy (10 cases), colostomy (1 case) and caecostomy (3 cases). This new syndrome has been experimentally studied, but its etiology remains obscure. It introduces a bad prognostic component in aganglionism. Ileocaecoplication, a very simple operation, can be a lifesaving procedure.
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PMID:[Ileocaecal valve incompetence. A new syndrome (author's transl)]. 74 65

The diagnosis of Crohn's disease in 13 patients (ten females and three males) at the Howard University Hospital during the ten-year period, 1965-1975, is examined. The most common presenting symptoms were right lower quadrant (RLQ) pain, diarrhea, anorexia, weight loss, and vomiting, while the most common physical finding was RLQ tenderness. Ileocolic involvement occurred most frequently. Eight patients had surgical resection. The most frequent operation was ileocolic resection with ileo-ascending colostomy. The chief indications for surgery were: (1) presumed appendicitis, (2) intestinal obstruction, and (3) internal fistulae.Crohn's disease seems to occur in blacks much less frequently than in whites. When compared to series of white patients reported by others, the series studied here has more females and more ileocolic involvement. In most other series, the greatest involvement is in the "ileum only" group.
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PMID:Crohn's disease in black patients. 85 35

Nonischemic intussusception is defined as a variant of acute intussusception exhibiting less acute symptoms of abdominal pain, vomiting, and diarrhea in the older child, longer duration of symptoms (usually 4-14 days), signs of imcomplete bowel obstruction, and absence of intestinal ischemia. Over a 10 yr period (1964-1973) 20 children with this disease were treated without mortality or recurrence at three children's hospitals in Chicago, Illinois. The higher incidence of diarrhea, the lower incidence of a palpable abdominal mass, and the lower incidence of blood per rectum in nonischemic intussusception predispose to diagnostic errors and delays in treatment. Despite the longer duration of symptoms, this variant of intussusception can be treated initially with a careful attempt at barium hydrostatic reduction. If this fails, easy operative manual reduction is the rule.
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PMID:Nonischemic intussusception. 89 56


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