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)

A Phase I / II study of docetaxel (DOC) and cisplatin (CDDP) combination therapy was conducted. The respective recommended dose (RD) in a phase I study was DOC 60 mg/m(2) and CDDP 80 mg/m(2). We performed a multicenter phase II study to assess the antitumor activity and toxicity of this RD. Patients with recurrent or unresectable squamous cell carcinoma of the head and neck were eligible. For inclusion in this study, patients were required to be >or=20<70 years of age with a Performance Status of 0 to 2. Adequate bone marrow as well as adequate renal and liver function were required. We assessed 22 patients, 13 of whom were enrolled in the phase II study, and 9 patients in phase I were given the RD. Grade 3 or higher neutropenia occurred in 12 patients (55%). There was no episode of febrile neutropenia of more than 3 days or grade 4 neutropenia of more than 3 days receiving G-CSF. Nausea was the most frequent toxicity, but only one patient experienced vomiting of more than grade 3. Pneumonia (grade 3), thrombocytopenia (grade 4) and emphysema (grade 2) were observed. No one achieved a complete response (CR) and 5 achieved a partial response (PR), for an overall response rate of 22.7% (5/22). Stable disease (SD) was seen in 11 and progressive disease (PD) in 6. In 21 of 22 patients, a relapse occurred despite previous treatment. For this population, the response rate was 19.0% (4/21).
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PMID:[A Phase II study of docetaxel and cisplatin in patients with recurrent or unresectable squamous cell carcinoma of the head and neck]. 1969 66

Pneumomediastinum is defined as free air or other gases contained within the mediastinum. In children it is an uncommon clinical condition with good prognosis. It most frequently occurs with exacerbations of asthma but also may occur after cough, vomiting, excessive valsalva maneuver and after the first wheezing attack as well. The first-line treatment for pneumomediastinum is to relieve the inciting factor. Otherwise, no specific therapy is recommended for uncomplicated cases, three boys, with the ages of 4, 8 and 13, presented in the emergency department, each after a few days of shortness of breath and respiratory distress. Chest radiography revealed pneumomediastinum and subcutaneous emphysema which had occured after severe asthmatic attacks. All of these patients have improved spontaneously with conservative treatment.
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PMID:[Pneumomediastinum and subcutaneous emphysema during asthmatic attacks in three patients]. 1971 16

An esophageal perforation occurred during an esophagogastroduodenoscopy (EGD). The patient had an episode of retching and forceful vomiting just after an esophageal mucosal biopsy at the gastroesophageal junction. The only clinical feature demonstrated by the patient was neck crepitation after completion of the EGD. Initial evaluation of the referred patient by posterior and lateral chest x-rays revealed extensive pneumomediastinum with subcutaneous emphysema. A unique chest computed tomography scan demonstrated suspension of the esophageal mucosal surface and lumen in a "bull's eye" configuration. A water-soluble esophageal swallow followed by a thin liquid barium swallow demonstrated that the esophageal perforation had sealed. The patient completely recovered with conservative medical therapy of clear liquid diet and antibiotics.
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PMID:Esophageal perforation during esophagogastroduodenoscopy. 1988 78

An 18-year-old male with type 1 diabetes mellitus presented to the emergency department after one day of lethargy and vomiting. Physical examination revealed a dehydrated male with tachycardia and Kussmaul's respiration. There was subcutaneous emphysema in both supraclavicular regions. Chest auscultation revealed a positive Hamman's sign. Laboratory investigation was significant for metabolic acidosis with venous blood pH 7.08. Plasma glucose was 1438 mg/dl; ketones were present in the urine. Chest X-ray showed subcutaneous emphysema and pneumomediastinum, which resolved spontaneously within 72 hours of initiation of treatment for diabetic ketoacidosis.Pneumomediastinum is an uncommon complication of diabetic ketoacidosis. Recognizing that severe diabetic ketoacidosis may cause pneumomediastinum allows for expedient management.
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PMID:Diabetic ketoacidosis with pneumomediastinum: a case report. 1991 51

Boerhaave's syndrome, first described in 1724, is a spontaneous transmural perforation of the oesophagus, typically caused by forced emesis. It is classically associated with the 'Mackler triad' of vomiting, lower thoracic pain and subcutaneous emphysema. It is the most lethal perforation of the gastrointestinal tract with an estimated mortality of 20-40% (de Schipper et al, 2009).
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PMID:Boerhaave's syndrome complicating status epilepticus. 2008 46

Microlaryngeal surgery is a common and relatively safe otorhinolaryngological surgery. Its common complications include pain and numbness of the tongue, bruising of the lip, and chipped teeth. However, reports of subcutaneous emphysema of the neck with pneumomediastinum following microlaryngeal surgery are rare. A 69-year-old female developed swelling of her left-side cheek and neck after microlaryngeal surgery for anterior glottic web. Palpation revealed subcutaneous emphysema and computed tomography demonstrated pneumomediastinum. The patient was managed conservatively, with complete resolution of symptoms within 2 weeks. Our observations suggest that emphysema likely resulted from increased intrapharyngeal pressure secondary to coughing, vomiting, straining, or manual ventilation after extubation provoked by disruption of the pharyngeal mucosa over the left anterior tonsillar pillar during insertion of the laryngoscope. Although microlaryngeal surgery is considered a relatively safe surgical procedure, it may be associated with significant complications. The procedure should be performed carefully to prevent mucosal injury.
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PMID:A rare complication after microlaryngeal surgery: subcutaneous emphysema and pneumomediastinum. 2068 96

Boerhaave's syndrome is the rare and often fatal condition of spontaneous esophageal rupture. Meckler's triad of vomiting, pain and subcutaneous emphysema are characteristic features of Boerhaave's syndrome. When these symptoms are absent, diagnosis is frequently late and often occurs as the result of incidental investigation. This contributes to the observed high morbidity and mortality. Unless specifically considered in the differential diagnosis, this rare disease is frequently overlooked. The authors described the case of a patient in whom the diagnosis was made several days following presentation by observing that a large pleural effusion had evolved rapidly on chest radiographs. This uncommon radiological sign has relatively few causes and prompted a review of the history and diagnosis, followed by the initiation of additional investigations that confirmed Boerhaave's syndrome.
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PMID:Boerhaave's syndrome - rapidly evolving pleural effusion; a radiographic clue. 2093 23

Gastric emphysema encompasses a broad spectrum of diseases. A 31-year-old woman presented with severe vomiting and epigastric pain. She had lost body weight for several months, and was later diagnosed as having anorexia nervosa. A radiological study demonstrated intramural gas with huge gastric dilatation and portal venous gas. She underwent total gastrectomy and was rescued from extensive gastric necrosis. Her clinical findings suggest that extraordinary dilation of the stomach increased the intraluminal pressure, thereby resulting in perfusion disturbance and extensive gastric necrosis. There are five other case reports of gastric emphysema associated with eating disorders in the literature. All but one were young women, and one of 4 patients with massive gastric necrosis died due to septic shock. Eating disorders cause gastric emphysema through several unique mechanisms, including gastric muscular atrophy, occlusion of the gastroesophageal junction, and delayed gastric emptying. Gastric emphysema in relation to eating disorders carries a risk of life-threatening complications and requires urgent diagnosis and treatment.
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PMID:[Gastric emphysema, a critical condition accompanied by eating disorders: a case report]. 2093 14

We present the case of a 79-year-old man admitted to the emergency room. Having anorexia and vomiting as main complaints, combined with abdominal distension and discomfort, diagnostic examination revealed a giant left inguinal hernia containing the antrum and pylorus of a dilated stomach, creating an outlet obstruction. This was complicated with free peritoneal air, gastric emphysema and air in the portal system due to ischaemia.
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PMID:Rare cause of gastric outlet obstruction: incarcerated pylorus within an inguinal hernia. 2239 46

Spontaneous pneumomediastinum during labour is a rare, usually benign and self-limiting condition. It often presents with chest or neck pain and surgical emphysema. The latter sign is easy to demonstrate but often missed during clinical assessment if the condition is not included in the differential diagnosis of chest pain and dyspnoea in peripartum. The authors describe a case of 20-year-old primigravida who developed surgical emphysema following prolonged vaginal delivery. The chest x-ray revealed pneumomediastinum, and small left apical pneumothorax. She was investigated with CT of the chest and contrast swallow, both of which excluded oesophageal perforation. The management was conservative and she made a complete recovery. Spontaneous oesophageal rupture is a potential cause of pneumomediastinum and leads to high morbidity and mortality if not diagnosed early. However, it is extremely uncommon in labour, especially without a preceding history of vomiting. Unless a strong clinical suspicious exists, routine investigations and or treatment of suspected oesophageal perforation are unnecessary.
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PMID:Postpartum pneumomediastinum manifested by surgical emphysema. Should we always worry about underlying oesophageal rupture? 2268 38


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