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

Seventy-five patients underwent a 90 percent distal gastric bypass for morbid obesity. The average weight was 121.4 kilogram, height 164 centimeters, and age 31.4 years in these 70 women and five men. There was a total of 20 surgical complications in the 75 patients, with wound infection being the most common. Sixteen chronic complications were noted and consisted of vomiting, diarrhea, reflux esophagitis, dysphagia, and vitamin deficiencies. None of the above complications were life-threatening or required dismantling of the bypass. Of 54 patients followed for 12 months or more after gastric bypass, there was a 24.5 percent average weight decrease at 6 months, and this progressed to 35.8 percent by 12 months. Fifty-two patients undergoing small bowel bypass previously at the same institution had a 25.4 percent weight reduction at 12 months. Of 54 patients, 83 percent followed for one or more years after gastric bypass have had an excellent or good clinical result, whereas only 42 percent of the 52 patients undergoing small bowel bypass have had an excellent or good clinical result with the same criteria. It is concluded that the Mason 90 percent distal gastric bypass is a suitable form of surgical treatment for the morbidity obese patient who cannot lose weight by dietary measures.
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PMID:Gastric bypass for morbid obesity: results and complications. 96 34

Adjustable gastric banding is the least invasive operation for morbid obesity. Forty-eight patients underwent surgical adjustable gastric banding between March 1990 and August 1991. In 15 of these patients, radiological examination was performed in the early postoperative period because of dysphagia and vomiting, revealing stenosis of the stoma in all cases (caliber less than 0.3 cm); in all patients we easily punched, with fluoroscopically guided observation, the inflatable portion and obtained a true calibration of the gastric banding. In seven patients radiological examination was performed 2 months after surgical treatment because of a lack of weight loss. Radiological findings explain surgical failure, revealing a too wide stoma in four patients, the absence of a gastric pouch due to a too high position of the band in two, and the caudal sliding of the banding in one patient.
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PMID:Adjustable silicone gastric banding for obesity. 161 2

Since 1984, a total of 99 patients underwent vertical banded gastroplasty (VBG) through protocol (pouch 8 ml in size, band 4.3 cm in circumference) to treat morbid obesity. Follow-up was obtained in 95 patients. Thirty upper gastrointestinal endoscopies were performed post-operatively in 17 patients. Indications were nausea/vomiting in 11, epigastric pain in 4, acute obstructive symptoms in 4, and miscellaneous in three. Findings included food impaction in 10, distal esophagitis in 8, gastritis in 4, and a normal examination in 2. Only 4 of 10 food impactions were associated with an excessively narrowed gastroplasty outlet. Eight patients had an excessively narrowed gastric stoma: two became asymptomatic with dietary modification only and six underwent dilation therapy (dilator range from 8 to 18 mm in diameter) with immediate resolution of symptoms in four of six. One of the two patients unresponsive to dilation was lost to follow-up, and the other required surgical revision after multiple dilation sessions.
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PMID:The role of endoscopy after vertical banded gastroplasty. 161 78

Vertical banded gastroplasty is the most common operation for morbid obesity. Postoperative gastroscopy was needed 91 times in 79 of 696 patients for 1) abdominal pain (23), 2) excess vomiting (22), 3) inadequate weight loss (14), 4) excess weight loss (13), 5) and a sudden increase in eating capacity (7). A normal appearance consisted of a clean gastric channel 6.8 +/- 1.4 SD cm long, with a rosette 46.6 +/- 2.1 cm from the incisors and, with insufflation, an 11 mm scope passed through this pseudopylorus snugly, but without difficulty. In Group 1, no problem was seen in the channel, and cholecystitis was found to be the cause. In Group 2, no problem was observed in ten (poor teeth and chewing), six experienced stasis or pill ulcerations, four had bezoars (fragmented or removed with basket), and two had intraluminal mesh. In Group 3, the scope floated through too large an outlet (greater than or equal to 13 mm) in eight, and no cause was seen in six (gorgers, sweets-eaters). In Group 4, tightness or stricture resolved with dilatations (Eder-Puestow; Savary; balloon dilators) in six, but seven required re-operation. In Group 5, the scope travelled through four breakdowns in the partition and three outlets were too large. Gastroscopy viewed problems accurately, indicated treatment and suggested modifications in gastroplasty technique.
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PMID:Endoscopy of vertical banded gastroplasty. 271 5

A 39-year-old man had protracted vomiting after gastric plication for morbid obesity. Within three months he lost 53 kg in weight and developed neuromuscular weakness, especially in the lower extremities. Clinical and laboratory studies suggested both radicular and peripheral neuropathy. One year later the condition was only marginally improved: he took only few steps unsupported. The apparent etiology is malnutrition but the primary cause remained unknown.
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PMID:Morbid obesity, gastric plication and a severe neurological deficit. 299 37

We report the occurrence of neurologic complications in 23 patients who underwent gastric restriction surgery for the treatment of morbid obesity. Complications occurred 3 to 20 months after surgery. All the patients had had protracted vomiting for the first 3 months after the operation. The following syndromes were found: chronic or subacute symmetric polyneuropathy (12 patients), acute severe polyneuropathy (1 patient), burning feet syndrome (2 patients), meralgia paresthetica (3 patients), myotonic syndrome (1 patient), posterolateral myelopathy (2 patients), and Wernicke-Korsakoff encephalopathy (2 patients). The patients suffering from burning feet syndrome and those with Wernicke-Korsakoff encephalopathy showed a clear improvement after parenteral thiamine treatment. As to the rest of the patients, the occurrence of the complications seems to be linked to nutritional causes, although no such deficiencies were detected.
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PMID:Neurologic complications after gastric restriction surgery for morbid obesity. 302 10

During the years 1981-85, 163 patients were treated with gastric banding for morbid obesity. Mean preoperative body weight (+/- s.e.m.) was 121.3 kg +/- 1.4, and mean overweight was 71.5% +/- 1.6 according to Broca's formula. Twenty-four patients had postoperative complications during the first 30 days, mostly minor. Four required reoperation and one of these died. Seventeen patients had late complications, six persistent vomiting necessitating reoperation, eight incisional hernia and three penetration of gastric wall by band. The weight loss was rapid during the first 6 months, and thereafter levelled off. After 2 years the weight loss was 33.4 kg +/- 2.4, corresponding to a mean weight loss of 27.6 percent +/- 1.9 of preoperative weight. There was no significant difference in weight loss expressed as a percentage of preoperative weight between patients operated with an outlet of 12 mm (45 patients) or 15 mm (118 patients), nor between males (37 patients) or females (126 patients). We conclude that our technique of gastric banding seems to be a relatively safe and reliable surgical treatment for morbid obesity. But our follow-up period has been limited to 2 years or less, and a longer follow-up is necessary before the method can be fully evaluated.
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PMID:Gastric banding for morbid obesity: early results. 366 69

A neuropsychiatric syndrome developed in four patients 2 1/2-9 months after gastric partition for morbid obesity. Since the partition, all four patients had recurrent severe vomiting with severe weight loss (52 to 100 lb) and they had not had vitamin supplementation. Two patients had peripheral neuropathy along with confusion and memory loss of recent events. The other two had peripheral neuropathy alone. Vitamin B complex replacement was especially helpful in the management of these patients. Peripheral neuropathy completely resolved in one of the patients, whereas the other three patients were left with residual weakness in their extremities and two had recent memory loss. Awareness of this complication may result in early recognition and treatment in the postgastric partition patient.
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PMID:Neuropsychiatric syndromes after gastric partition. 630 87

Two weeks after gastric partitioning for morbid obesity, a 45-year-old woman experienced persistent vomiting that led to a weight loss of 30 kg over 6 weeks. Wernicke's encephalopathy and peripheral neuropathy developed. The Wernicke's encephalopathy responded well to the administration of thiamine. This is one of very few reported cases of Wernicke's encephalopathy following gastric partitioning.
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PMID:Wernicke's encephalopathy after gastric partitioning for morbid obesity. 670 23

We have observed 16 cases of stomal stenosis occurring late after gastric surgery for morbid obesity. In one patient no stoma was apparent in the pouch on radiographic or endoscopic examination and reoperation was required for complete obstruction. We dilated stenoses in the remaining 15 patients. Stenosis in the three earliest patients in our series were dilated with Eder-Puestow dilators. All subsequent patients have received endoscopic dilation with pneumatic balloon catheters. Ten patients remain asymptomatic following dilation. Two patients have occasional vomiting, which is ameliorated by metoclopramide hydrochloride, despite a sufficiently patent stoma. Two patients with a torsion of the stoma received no benefit from dilation, and one patient with a sufficiently patent stoma has experienced frequent vomiting. Surgery has been repeated in the latter three patients. The technique of endoscopic pneumatic balloon catheter dilation is a safe and effective means of dilating stomal stenoses occurring late after gastric surgery for morbid obesity.
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PMID:Endoscopic dilation of late stomal stenosis. Its use following gastric surgery for morbid obesity. 673 93


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