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)

Gallstones are usually silent. Less commonly, patients with cholelithiasis develop symptoms and/or complications; biliary fistula occurs in 3% to 5% of the cases. When a large stone is passed and occludes the duodenum, gastric outlet obstruction (the Bouveret syndrome) may result. In reported cases, the stones are usually larger than 2.5 cm. The usual presenting symptoms are those of bowel obstruction: abdominal pain, nausea, and vomiting. Less commonly, the patients experience melena and, rarely, hematemesis. We describe a patient who had the largest stone reported to cause hematemesis rather than bowel obstruction and to be diagnosed endoscopically. The 5 X 4 X 3 cm stone was extracted surgically. Endoscopic diagnosis and extraction of stones up to 3 cm in size has been reported, avoiding the need for surgery.
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PMID:The Bouveret syndrome: an unusual cause of hematemesis. 222 12

The case of a 74 years old woman suffered from a gallstone disease for 5 years is reported. In the background of the upper abdominal pain and vomiting, which necessitated her hospitalization, a large-size gallstone penetrated into the duodenal bulb and obstructed pyloric channel was found by endoscopic examination. The upper duodenal ileus was verified during the operation, gastroduodenotomy and cholecystectomy were performed, and the 7 x 4 cm size gallstone was removed. After a complications free period the asymptomatic patient went home. Our above reported case is a preoperatively, endoscopically diagnozed Bouveret's syndrome.
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PMID:[Bouveret syndrome diagnosed by endoscopy]. 226 63

A 5-year-old girl presented with headache, vomiting, flushing, ptosis, and paroxysmal tachycardia. The neurological findings were partial motor and sensory left trigeminal palsy, left conductive hearing defect, and left cerebellar deficit. The radiological and neuropathological findings were typical for trigeminal schwannoma, which is rare in childhood. The present patient is the youngest yet recorded.
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PMID:Trigeminal schwannoma in a child. 647 86

Bouveret's syndrome, or gallstone duodenal pyloric obstruction, almost always presents with abdominal pain or vomiting. It occurs more commonly in females (65%), with a median age of 68.6 years. The diagnosis is made by endoscopy (60%), upper gastrointestinal series (45%) or by direct abdominal x-ray (23%). The syndrome is mainly treated by surgery (93%), but recently, it has also been treated by endoscopy or extracorporeal shock wave lithotripsy. The mortality rate has improved from 33%, as was the case before 1968, to 12% in recent years. Herein we report the case of a 79-year-old female with Bouveret's syndrome.
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PMID:Bouveret's syndrome: case report and review of the literature. 926 92

Gastric outlet obstruction caused by a large gallstone in the duodenum or pylorus (Bouveret's syndrome) is a rare complication of gallstone disease. The presenting symptoms are often nonspecific and include nausea, vomiting, epigastric pain and a history of gallbladder disease. Although the diagnosis is established only at surgery in many cases, preoperative recognition by imaging techniques and endoscopy is desirable. Surgical treatment aims at removal of the ectopic gallstone, closure of the fistula and cholecystectomy. A case of Bouveret's syndrome is presented where endoscopic extraction of the duodenal gallstone was accomplished providing definitive treatment for this patient.
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PMID:Duodenal obstruction by a gallstone (Bouveret's syndrome) managed by endoscopic stone extraction: a case report and review. 958 39

We report a case of Bouveret's Syndrome (gastric outlet obstruction by gallstone) and gallstone emesis, both of which are very rare, in a 77-year old Ghanaian woman. Diagnosis depends on high index of suspicion and confirmation with endoscopy. Definitive treatment consist of enterotomy plus stone retrieval with primary excision of the diseased gallbladder and repair of the duodenal fistula.
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PMID:Gallstone impaction in the duodenal bulb: an uncommon cause of gastric outlet obstruction associated with gallstone emesis. 971 20

Bouveret's syndrome involves gastric outlet obstruction by gallstone. Herein we describe an unusual case of duodenal bulb obstruction by gallstone. An 80-year-old woman was hospitalized with a fifteen-day history of vomiting. Computed tomography (CT) showed pneumobilia and a round calcified mass in the second portion of the duodenum. Upper gastrointestinal tract series demonstrated the same sized oval radiolucency between the bulbus and the second portion of the duodenum. Endoscopic examination revealed a round black mass in the second portion of the duodenum, totally occupying the lumen. Endoscopic removal and destruction of the gallstone was attempted using a dye-laser, but the stone was too hard to crush. Eventually surgical enterolithotomy was successfully performed without cholecystectomy or closure of the fistula. Improved preoperative systemic management and prompt examination allowed earlier surgical intervention and reduced the morbidity. Surgical approach whether fistula closure should be performed remains controversial.
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PMID:Duodenal obstruction by gallstone: case report of Bouveret's syndrome. 1036 20

Gastric outlet obstruction caused by a gallstone in the duodenum or pylorus(Bouveret's syndrome) is a very rare complication of gallstone disease. Presenting symptoms include epigastric pain, nausea, and vomiting. Preoperative diagnosis is not easy. Oral endoscopy is one of the diagnostic procedures. We present a case in which the diagnosis was made by endoscopic examination. Multiple attempts at endoscopic extraction of the gallstone from the duodenum were unsuccessful. A one-stage surgical procedure consisting of the removal of the impacted stone, fistula repair, and cholecystectomy was performed in this case. The postoperative course was uneventful.
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PMID:Gastric outlet obstruction by a gallstone (Bouveret's syndrome). 1085 23

Bouveret's Syndrome is obstruction of the duodenum secondary to an impacted gallstone, usually without the presence of pneumobilia. With the steadily increasing life expectancy, greater numbers of these cases are being seen. Gallstones enter the gastrointestinal tract following fistula formation between the gallbladder and an adjacent hollow viscus and may cause obstruction at any point along the intestinal tract. Duodenal obstruction is the least common and represents only a very small percentage of cases. The presenting signs of nausea vomiting, abdominal cramping, and the absence of abdominal distension should alert the clinician to pathology in the proximal small bowel. The purpose of this report is to heighten the awareness of the primary care physicians, emergency room doctors, and surgeons to this diagnosis in elderly patients so that it can be included in the differential with the usual causes of gastric outlet obstruction--including ulcer disease; neoplasm; gastric volvulus; and other enteroliths, such as bezoars. Early diagnosis is critical, as these cases require urgent surgical intervention. Early resuscitation, diagnosis, and treatment are essential for a successful outcome.
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PMID:Bouveret's syndrome: revisiting gallstone obstruction of the duodenum. 1462 Jul 10

Duodenal obstruction due to a gallstone from a cholecystoduodenal fistula (Bouveret's syndrome) is a rare complication of gallstone disease. Patients present gastric outlet occlusion with vomiting, abdominal distension and a state of dehydration. Plain film of the abdomen, ultrasonography and CT scans reveal pneumobilia and the obstructing gallstone. Endoscopy is essential for diagnosis and therapy, with a view to the possibility to relieving the occlusion. Endoscopy, however, cannot be used to treat the fistula and is often unsuccessful because of the very large size of the stone. Surgical therapy can be effective both for relieving the occlusion and for fistula treatment. The authors report a case of Bouveret's syndrome successfully treated surgically in an otherwise healthy patient. In critically ill patients, the primary goal of therapy is relief of the occlusion.
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PMID:Bouveret's syndrome: a case report. 1528 46


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