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)

The case of an 18-year-old man with sigmoid volvulus and recurrent abdominal pain is presented. He was seen in the emergency department three times in a 4-month period, each time complaining of cramping left lower quadrant pain of one to two hours duration without vomiting or diarrhea. Physical examination on each occasion revealed left lower quadrant tenderness without mass, guarding, or rebound. Radiologic evaluation on the first visit revealed sigmoid volvulus, which was reduced by barium enema. Despite identical clinical presentation on two subsequent occasions, radiologic studies showed no evidence of recurrent volvulus. During the ensuing two years, the patient has had no further symptoms.
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PMID:Sigmoid volvulus in a young patient. 647 22

Four children (ages 3-9 years) with intermittent abdominal pain and vomiting are reported. Upper gastrointestinal examinations revealed a sharply angulated to-and-fro course (Z configuration) of the distal duodenum and proximal jejunum, rather than the usual smooth duodenojejunal loop at the ligament of Treitz. At operation this configuration was associated with broad peritoneal bands extending across the involved small intestine without an accompanying volvulus at this level. The Z sign is diagnostic of incomplete rotation, even in the absence of duodenal obstruction and with a proximal jejunum that may appear to be properly placed.
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PMID:Z-shaped duodenojejunal loop: sign of mesenteric fixation anomaly and congenital bands. 660 51

One is tempted to believe that volvulus in elderly patients on many occasions may be preceded by inactivity and pseudomegacolon. Owing to psychiatric problems, chronic illness, or institutionalization, the patient is more likely to be subjected to treatment with sedatives and psychotropic drugs, causing decreased neuromuscular function of the gut. The basic principles in treating the volvulus are releasing the volvulus, deciding whether a nonoperative or an operative procedure should be employed, and treating complications. As far as surgical management is concerned, several techniques have been suggested, some of which are still controversial. Colonoscopy appears to have become an important method of treatment for volvulus with clearly established indications. Oddly enough, already hospitalized patients are occasionally subjected to delayed attention for volvulus. Therefore, physicians responsible for the care of geriatric patients should be alerted by even fairly mild symptoms of distention, abdominal pain, vomiting, and constipation. Clinical evaluation, including routine films of the abdomen, may avert a major catastrophe.
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PMID:Colon volvulus and the geriatric patient. 707 92

Idiopathic gastric volvulus is not rare, especially in the neonate and in infancy. Between 1966 and 1980 we managed 44 cases of gastric volvulus. In 22 of the cases, initial examination was performed under 1 year of age. The main symptoms in this group were vomiting and abdominal distention, while those in the group over 2 years of age were abdominal distention, weight loss, nausea, appetite loss etc. The upper G.I. series were the most important in diagnosis. There was only one case of acute volvulus, which was treated operatively on an emergency basis. Chronic volvulus could be treated conservatively, except in 2 cases. This consisted in the positioning of the patient in the upright right recumbent position after feeding, for at least 1 hour. In the supine position, the gastric fundus is filled and dilated when the milk is poured into the stomach, the fundus is pulled postero-caudally and the antrum is pulled upwards, resulting in the combined type of organo-axial and mesenterico-axial volvulus. Over 2 years of age, 77% required operation. The fixation of the gastric fornix with the diaphragm was performed, using 5 or 6 stitches. The result was quite satisfactory. We recommend this procedure in this operation.
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PMID:Idiopathic gastric volvulus in infancy and childhood. 728 54

This paper describes a simple and effective fluoroscopic technique that remarkably improves diagnostic accuracy when evaluating vomiting newborns. The technique also minimizes the time of the examination and the radiation dose to the patient and radiology personnel. Several examples are presented illustrating the superiority of gloved hand or nonopaque compression technique to conventional contrast radiography, emphasizing babies with pyloric stenosis and midgut malrotation. The technical limitations and diagnostic pitfalls of conventional contrast modalities are compared to the highly diagnostic images obtained with manual compression fluoroscopy. All of the classic radiographic signs of pyloric stenosis can be mimicked by antral spasm or pylorospasm. Gloved hand compression overcomes antral spasm and clearly shows the true length and diameter of the pyloric canal in these two conditions. Malposition of the duodenojejunal junction is the only consistently diagnostic sign of midgut malrotation. Nonfixation of the duodenojejunal junction can be competently assessed by compression fluoroscopy, confirming malrotation and midgut volvulus simultaneously and bringing the patient to operation much sooner than with less precise conventional techniques. Gloved hand compression technique also evaluates stenotic areas in the upper gastrointestinal tract, distinguishing spasm from organic marrowing and clearly identifying those which need surgical intervention. Facilitating intubation of the duodenum is a final contribution of compression fluoroscopy.
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PMID:Diagnostic advantages of manual compression fluoroscopy in the radiologic work-up of vomiting neonates. 738 60

Authors report the case of a newborn with a sudden picture of abdominal distension, bilious vomiting and blood stools due to a twisted ovarian cyst with ileal volvulus. Patient cured after surgical excision of both ovary and necrotic bowel. A high perinatal gonadotrophic activity could be at the origin of neonatal ovarian cycts. Association with ileal volvulus seems to have been reported only in three other instances.
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PMID:[Ovarian intestial syndrome. (authors transl)]. 741 44

A review of the world literature has revealed only 11 cases of gastric volvulus symptomatic in the first month of life. To those 11, this report adds two cases of intrathoracic organoaxial gastric volvulus that were observed in the first week of life and were managed operatively. Gastric volvulus should be considered in the differential diagnosis of newborn infants initially observed to have persisting regurgitation, vomiting, and respiratory distress. The diagnosis can be made with plain thoracoabdominal roentgenograms and confirmed by upper gastrointestinal contrast studies. Prompt surgical management is indicated and should include reduction and fixation of the stomach and repair of associated anomalies. The results of early surgery are excellent.
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PMID:Gastric volvulus in the newborn. 741 51

Seventy-four patients were operated on at Childrens Hospital of Los Angeles between 1951 and 1977 for abnormalities of intestinal rotation with or without volvulus. The mortality in this group of patients was 4% and represents a significant improvement from the 23% mortality previously reported from this institution between 1937 and 1951. Neonatal patients had bilious vomiting and signs of high intestinal obstruction while older children had a more chronic course characterized by intermittent episodes of abdominal pain. Evaluation with contrast studies and early celiotomy is mandatory to prevent bowel necrosis. We outline the associated gastrointestinal anomalies and management of these combined anomalies.
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PMID:Malrotation of the midgut in infants and children: a 25-year review. 746 43

A case of vomiting and selective epigastric pain secondary to volvulus of the pedicle of a liver accessory lobe, in an infant, is reported. Ultrasonic findings are useful and probably sufficient for a correct diagnosis.
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PMID:Liver accessory lobe torsion in the infant. 759 65

The records of 54 pediatric patients with symptomatic malrotation of the intestine seen over a 15-year period from 1978 to 1992 were reviewed. Bilious vomiting and bloody stools were the two most common clinical presentations in neonates, while bilious vomiting, recurrent abdominal pain and failure to thrive were the most common symptoms after the newborn period. Obscure symptoms, usually of appreciable duration, were common in many patients beyond infancy. Upper gastrointestinal radiologic examination is the preferred and more accurate method of diagnosing malrotation as it has greater sensitivity than barium enema study. Laparotomy showed 24 cases with midgut volvulus. The incidence of midgut volvulus in symptomatic malrotation was 42.1% in the neonatal period, and 50% beyond the neonatal period. The majority of patients were treated by Ladd's operation. Massive gangrene of the small bowel due to volvulus was noted in five neonatal cases. Three patients subsequently died of this complication. Four patients developed a bowel obstruction secondary to adhesions, which was relieved by enterolysis. This study reiterates that newborns with symptomatic malrotation require emergency laparotomy in order to prevent catastrophic massive bowel resection.
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PMID:Intestinal malrotation and midgut volvulus: a 15-year review. 760 79


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