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

Two men, aged 52 and 57 years, had vomited and then developed chest pain, dyspnoea and tachypnoea. After a myocardial infarction had been excluded in the cardiac emergency room, further examination revealed a rupture of the oesophagus. This was treated surgically with the ultimate creation of a tubular stomach. Both patients then recovered well. The Boerhaave's syndrome, a 'spontaneous' perforation of the oesophagus, is a rare and potentially lethal condition which should be diagnosed at an early stage. Pain in the chest, dyspnoea and vomiting are frequent symptoms. A cardiac cause is sometimes erroneously suspected. Subcutaneous emphysema is a major indication for a perforation of the oesophagus. The chest X-ray shows also mediastinal emphysema and infiltrative abnormalities; in case of doubt a second X-ray should be made some hours later.
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PMID:[Boerhaave's syndrome: also in the emergency room]. 1126 4

The authors present 3 cases of subcutaneous emphysema after postoperative vomiting treated during a 4-year period. All patients were female, they underwent positioning during general anaesthesia--rotation on their abdomen and they vomited postoperatively with subsequent development of subcutaneous emphysema. The course was benign in all cases after conservative treatment. The authors discuss the possible etiology, diagnosis and treatment.
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PMID:[Subcutaneous emphysema caused by postoperative vomiting]. 1178

This report describes a case of spontaneous esophageal perforation that was considered to be etiologically related to a duodenal ulcer with pyloric stenosis. The patient was a 54-year-old Japanese man who presented following the sudden onset of severe abdominal pain and dyspnea after an episode of vomiting. He had a history of duodenal ulcer. Computed tomography revealed an extremely dilated stomach containing abundant food residue, intraabdominal effusion, bilateral pleural effusion, and mediastinal emphysema, findings that strongly suggested esophageal perforation. Esophagoscopy confirmed perforation of the lower esophagus. Laparotomy revealed marked contamination, including food residue in the abdominal cavity, and a severely dilated stomach attributed to pyloric stenosis caused by a duodenal ulcer. A 2-cm longitudinal perforation was found on the right side of the lower esophagus. Because the patient's general condition was too poor to tolerate a one-stage operation (primary closure of the perforation, gastrectomy, and reconstruction), we initially performed decompression gastrostomy and control of the esophageal leakage with T-tube placement. Following the T-tube was removed 1 month later, distal gastrectomy and reconstruction of the gastrojejunostomy (Billroth II method) could be safely performed.
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PMID:Spontaneous esophageal perforation related to a duodenal ulcer with pyloric stenosis: report of a case. 1182 88

A triad of signs constitutes Boerhaave syndrome: forceful vomiting, chest pain and subcutaneous emphysema. The syndrome results from spontaneous rupture of the oesophageal wall leading to an oeso-pleural or oeso-mediastinal fistula. Positive diagnosis is established with a water-soluble swallow, sometimes coupled with computed tomography of the thorax. Boerhaave syndrome is a surgical emergency. We report three cases of spontaneous rupture of the oesophagus and analyze the importance of emergency surgery as well as emergency treatment of the sepsis, an important prognosis factor.
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PMID:[Spontaneous rupture of the esophagus or Boerhaave syndrome. Report of 3 cases and review of the literature]. 1188 72

A patient was diagnosed with pneumomediastinum caused by an esophageal rupture during hyperemesis gravidarum. The woman, at 15 weeks' gestation, presented with hyperemesis gravidarum complicated by an episode of chest pain and disturbance of consciousness. Radiological examination revealed pneumomediastinum and subcutaneous emphysema. They are normally caused by either pulmonary or esophageal rupture. The esophageal etiology was suspected as more likely because of the severe vomiting accompanied with it. Although the clinical feature was quite complicated and esophageal rupture is generally a life-threatening disease, we chose conservative therapy which resulted in rapid recovery. The final diagnosis was confirmed by endoscopic examination performed after recovery. Pneumomediastinum during pregnancy is rare but it could be lethal. Careful and considerate assessments including surgical treatment should be necessary.
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PMID:Pneumomediastinum following esophageal rupture associated with hyperemesis gravidarum. 1221 35

Spontaneous esophageal perforation is an uncommon finding requiring prompt diagnosis and immediate surgery because of its high mortality rate. Esophageal rupture secondary to severe vomiting in pregnancy is extremely rare and only four cases have been published in the literature. We report the case of a 20-year-old female in whom severe vomiting in early pregnancy resulted in esophageal perforation with subcutaneous emphysema. The diagnosis was made 48 h later. The patient had undergone surgical treatment and the postoperative period was uneventful. The unusual cause and the interesting clinical course of esophageal rupture are described.
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PMID:Spontaneous esophageal rupture following severe vomiting in pregnancy. 1244 98

Haemorrhage, penetration and perforation are common complications of peptic ulcers. Free intraabdominal air is seen in 80 % after perforation. Penetration into the retroperitoneum with pneumothorax and mediastinal emphysema are rarely observed. We report the case of a 85-year-old female patient with nausea, vomiting and little appetite. During endoscopy of the upper GI-tract she complained about progressive dyspnea. Chest X-ray revealed mediastinal emphysema and pneumothorax. When performing laparotomy, we found a duodenal ulcer, that had penetrated the retroperitoneal space. The patient underwent partial gastrectomy and reconstruction with Billroth-II anastomosis. The postoperative course was uneventful.
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PMID:[Duodenal ulcer presenting as pneumomediastinum and pneumothorax -- case report]. 1252 27

A 75-year-old man was seen in the Emergency Room of our hospital because of chest pain after drinking beer and vomiting. Chest radiography showed pleural effusion in the left pleural space. The drained effusion contained digested food. A chest CT scan demonstrated mediastinal emphysema and an esophageal tear. The contrast esophagogram confirmed the diagnosis of spontaneous rupture of the esophagus. The characteristic CT findings of esophageal tear could have been used alone for the diagnosis, without esophagography.
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PMID:[A case of spontaneous rupture of the esophagus: the characteristic CT findings]. 1293 81

Gastrointestinal and respiratory involvement is common in hereditary angioedema, laryngeal edema being the main cause of mortality in these patients. We report the case of an 18 year-old woman with a history of hereditary angioedema, who presented an episode of coughing and vomiting the night before, and who was diagnosed with pneumomediastinum as a complication of an episode of angioedema. We review the causes and pathogenesis of the mediastinic emphysema.
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PMID:Hereditary angioedema and pneumomediastinum. 1296 1

Postoperative nausea and vomiting-related subcutaneous emphysema is an unexpected complication, especially after uneventful surgery and anesthesia. Here we report and discuss two cases of subcutaneous emphysema following severe retching and vomiting which resolved spontaneously after several days.
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PMID:Subcutaneous emphysema following severe vomiting after emerging from general anesthesia. 1524 41


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