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)

Belching and severe vomiting may lead in association with gastro-oesophageal prolapse to a variety of lesions within the gastro-oesophageal junction. Incarceration of the prolapse, diffuse hemorrhage from the prolapsed mucosa, longitudinal lacerations (Mallory-Weiss syndrome), intramural hematoma and spontaneous rupture (Boerhaave syndrome) are the most common complications. Based on 4 cases of incomplete rupture of the oesophagus we would like to draw attention to a disorder with mediastinal emphysema or pneumopericardium following severe vomiting. It is postulated that air escapes from a mucosal tear in the terminal oesophagus into the mediastinum. Conservative treatment seems justified.
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PMID:[Incomplete spontaneous esophageal rupture - a variant of the Mallory-Weiss and Boerhaave syndrome?]. 688 Mar 17

An 81-year-old woman without any known previous disease was admitted for epigastralgia, nausea, vomiting and anorexia since 15 days. The investigations disclosed a pneumopericardium which was caused by the perforation of a gastric ulcer, situated on the collar of an hiatal hernia. A pericardial drainage and a suture of the ulcer were performed, but the patient could not be saved. Despite an optimal treatment composed of pericardial drainage, specific surgery and intensive care, the mortality rate of pneumopericardium is still around 50% proving the severity of this illness.
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PMID:[Pneumopericardium: a race against time! Case report and literature review]. 876 87

Spontaneous esophageal perforation, or Boerhaave syndrome, is an uncommon finding requiring prompt diagnosis and immediate surgery because of its high mortality rate. The clinical diagnosis in typical cases is based on the symptom triad of Macler: vomiting, strong sudden chest pain and subcutaneous emphysema. We report 4 cases of Boerhaave syndrome with atypical presentation studied with Computed Tomography (CT) to make the correct diagnosis with atypical clinical findings. In each patient, we assessed the clinical symptoms, classifying them as typical and atypical, the diagnostic course leading to diagnosis and CT patterns. The classic symptoms were absent in one patient, while one patient had vomiting only, one had vomiting and chest pain and one had chest pain and cough. Chest radiography was performed in three patients and permitted the diagnosis in one of them only. CT permitted the definitive diagnosis in all cases. When spontaneous esophageal rupture presents with aspecific clinical findings. CT permits its accurate and specific diagnosis. We found atypical CT signs of esophageal rupture, namely pneumopericardium, uncommunicating mediastinal and pleural effusions, and focal pleural effusion in a contralateral cavity. Finally, our finding of a periesophageal mediastinal collection moving to the parietal subpleural space is not reported in the radiological literature. The severity of these findings varies and it is probably related to the increase in intraesophageal pressure affecting the progression of abscessual and hydroaerial collections in different anatomical structures; the time when CT is performed is also important. To conclude, the CT diagnosis of spontaneous esophageal rupture is specific and CT shows lesion site correctly.
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PMID:[Spontaneous rupture of the esophagus (Boerhaave syndrome): computerized tomography diagnosis in atypical clinical presentation]. 942 52

Pneumopericardium is a rare but serious finding. It may indicate severe chest trauma and be associated with tracheobronchial and oesophageal injuries. On the other hand, oesophageal rupture such as Boerhaave's syndrome may also be accompanied by pneumopericardium. A case of spontaneous pneumopericardium and pneumomediastinum after alcohol-induced emesis is reported. Tracheal, bronchial, and oesophageal injury were excluded by radiology and endoscopy. Interstitial lung emphysema is discussed as the pathogenesis.
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PMID:[Pneumopericardium after hyperemesis. Possible result of the Macklin effect]. 1925 34

Pneumopericardium is a rare but potentially life-threatening clinical condition that must be considered in the differential diagnosis of chest pain. It is usually associated with chest trauma, infections, invasive procedures or mechanical ventilation. We report a case of pneumopericardium in a 25-year-old woman following a recent episode of forceful vomiting possibly acting as trigger factor. The diagnosis was made by posteroanterior chest radiography and confirmed with computed tomography. Contrast swallow test failed to detect oesophagopericardial fistulae and the patient was managed conservatively without further complication.
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PMID:The heart in an airbag: spontaneous pneumopericardium in a young lady. 2189 79

A 17-year-old girl presented to the A&E department with significant neck swelling with associated chest, neck and throat pain. She reported recreational inhalation of nitrous oxide and ingestion of MDMA (3,4-methylenedioxy-methamphetamine) in the preceding hours. There was no history of trauma or vomiting. Clinical examination revealed extensive subcutaneous emphysema. There was no airway compromise. A chest X-ray suggested the presence of a pneumomediastinum. Subsequent CT of the thorax confirmed an anterior pneumothorax and a pneumopericardium. The patient was admitted for observation and intravenous antibiotics. Further investigations ruled out an oesophageal perforation. The patient was discharged following a period of clinical stability and has since made an uneventful recovery. MDMA ingestion has been cited as a rare cause of spontaneous pneumomediastinum in a series of case reports. In this case, it is likely that the inhalation of nitrous oxide contributed to the development and expansion of a pneumomediastinum.
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PMID:Recreational nitrous oxide inhalation as a rare cause of spontaneous pneumomediastinum. 2639 41

Spontaneous pneumomediastinum is defined as free air or gas contained within the mediastinum, which almost invariably originates from the alveolar space or the conducting airways. It is rare in pediatric patients; however, occasional cases are reported to result from forced Valsalva's maneuver due to cough, emesis, a first attack of wheeze, or asthma exacerbations. We report the case of a 7-year-old previously healthy girl, with a history of persistent dry cough one day before, who was brought to our unit with face, neck and chest swelling. The chest X-ray and computed tomography (CT) scan showed subcutaneous emphysema with pneumomediastinum and pneumopericardium without evidence of the origin of this air leak. Laboratory tests and the bronchoscopy were normal. The patient was admitted in the pediatric critical care and received noninvasive monitoring, analgesia, oxygen, and omeprazole as a prophylaxis for a gastric ulcer. The patient improved, subcutaneous emphysema resolved, and she was discharged on the third day.
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PMID:A Case of Spontaneous Pneumomediastinum with Subcutaneous Emphysema in Children. 2941 95

Hamman's syndrome is a spontaneous pneumomediastinum and is described as a rare complication of diabetic ketoacidosis (DKA). It typically follows a self-limiting course after successful treatment of the underlying DKA. We describe a case of a 28-year-old woman with type 1 diabetes presenting with facial pain, vomiting and abdominal pain. She also complained of dyspnoea and chest pain. She was diagnosed and treated for DKA triggered by a dental abscess. Given the presentation during the coronavirus pandemic, a computed tomography pulmonary angiography was performed in line with the diagnostic pathway for COVID-19, which incidentally showed a significant pneumomediastinum and pneumopericardium. The patient was initially investigated for oesophageal rupture secondary to vomiting (Boerhaave's syndrome), however, remained clinically stable throughout. Follow-up computed tomography showed near-complete resolution of pneumomediastinum with no intervention other than treatment of DKA. This therefore confirmed Hamman's syndrome.We propose that given the benign nature of the condition and the incidental finding in this report, as well as poor identification of mediastinal gas on chest X-ray, Hamman's syndrome is more common than reported.
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PMID:Images of the month: An incidental finding of spontaneous pneumomediastinum (Hamman's syndrome) secondary to diabetic ketoacidosis during the coronavirus pandemic. 3319 39