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)

Premature infants presenting to the neonatal intensive care unit at the Hospital for Sick Children with a surgical abdomen over a 5-year period were studied retrospectively to determine the factors leading to the diagnosis of malrotation with volvulus and necrotizing enterocolitis (NEC). Fifteen preterm infants (less than 37 weeks) were diagnosed as having volvulus, and 54 had surgically treated NEC. Those with NEC were more likely to be systematically ill with grossly bloody stools, abdominal tenderness, and thrombocytopenia (P less than .005). Bilious vomiting and bilious gastric residuals were the only hallmarks of volvulus (P less than .005). Although the radiographic findings of thickened bowel walls and intramural air were significantly related to NEC, the accuracy and interobserver reliability in diagnosing these features was variable as was the ability to distinguish NEC from volvulus or normal on plain abdominal radiographs. Volvulus is an important cause of surgical abdomen in the preterm infant and can be misdiagnosed as NEC. An unusual course or the presence of bilious vomiting in any patient thought to have NEC should alert the clinician to the possibility of this diagnosis.
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PMID:Necrotizing enterocolitis and volvulus in the premature neonate. 277 84

Some clinical manifestations following exchange transfusion (ET) could result from graft versus host disease secondary to the introduction of viable foreign T lymphocytes: skin rash, fever, acute and sometimes bloody diarrhea or enterocolitis. Between February 1985 and January 1989 the blood used for 31 ET was irradiated at 40 grays. We compared the manifestations occurring during the days following ET to those occurring after 44 previous ET with non irradiated blood during the period January 1981 to January 1985. From 1981 to 1985, 13 of 44 infants developed problems within 3 days following ET: an erythematous macular skin rash in 4; gastrointestinal manifestations (diarrhea, vomiting and rectal bleeding, necrotizing enterocolitis) in 7; both skin lesions and a gastrointestinal problem in 2. Since 1985, 27 infants had no problems whereas only 4 developed gastrointestinal or cutaneous manifestations: NEC in a preterm infant, abdominal distension with rectal bleeding, fever and petechial rash in 2 infected infants. These data show a dramatic decrease of complications since the irradiation of blood products has been started: 30% with non irradiated, 13% with irradiated blood.
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PMID:[Neonatal exchange transfusion with irradiated whole blood. Preliminary results]. 278 1

A revision study of 322 cases of neonatal necrotizing enterocolitis (NEC) in a six year period at a pediatric hospital is presented. The frequency of NEC was 7.2% of the newborn (NB) admitted to the hospital. Fifty two percent corresponded to grade I on Bell's classification, 37% to grade II and 11% to grade III. Most of the cases were seen in at term newborn (51.3%) even though the proportional frequency in relation to the admissions was 38% in at term newborn and 62% in premature. The main clinical manifestations were abdominal distention, vomiting, and blood in feces. The frequency and intensity of other clinical signs as well as other signs as acidosis, anemia, hyponatremia and hypoprothrombinemia were directly proportional to the severity of the NEC. The radiological data of portal pneumatosis were more frequent in grade III NEC, and several cases of gastric pneumatosis were seen in the grade II NEC. Thirty four patients (10.6%) underwent surgery. The global mortality was 29.5% and in those who underwent surgery 79.4%.
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PMID:[Frequency of neonatal necrotizing enterocolitis at a pediatric hospital]. 278 35

During a 20-year period, eight term infants admitted to a large children's hospital for treatment of dehydration associated with diarrhea (6) and vomiting (2), and who ranged in age from 10 to 60 days at onset of symptoms and 18 to 75 days at presentation, developed distal small bowel obstruction following apparently successful rehydration. With the exception of a single infant who was dead on arrival, and another whose obstruction went unrecognized, all infants came to operation shortly after obstruction was confirmed. In each case, a severely inflamed area of distal ileum (7) or proximal colon (1) was found at autopsy (2) or operation (6) to be the cause; perforation was present in four of the cases. Resection of the diseased segments of intestine, and primary anastomosis, were performed in all six operated cases; reoperation was required in four of the six for leaks (3) and adhesions (1). All but two survived. Pathologically, the resected intestinal segments showed a unique pattern of injury: numerous punctate ulcers were apparent, which undermined the muscularis mucosae, without evidence of necrosis. Regenerating epithelium extended through these defects, resulting in the presence of glandular invaginations, which were surrounded by a brisk inflammatory response: hence the term "microdiverticulitis." We believe this lesion represents a beginning or furtive attempt at repair of severely inflamed, but viable intestine, and that it is a rare but true cause of small bowel obstruction in early infancy, separate and distinct from necrotizing enterocolitis.
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PMID:Microdiverticulitis: a rare but distinct cause of small bowel obstruction in early infancy. 361 47

Fulminant, necrotizing colitis is a frequent, and generally fatal, complication of severe granulocytopenia, occurring during the treatment of hematological malignancies. In these cases, the patient complains of severe peritonitis, including nausea, vomiting, abdominal pain, diarrhea or melena, and a high temperature. Here, a rare case of anticancer chemotherapy-induced diffuse necrotizing enterocolitis throughout the entire intestinal tract is presented, which developed in a patient who did not have a hematologic malignancy but who had colon cancer, the only clinical symptom of which was watery stools, without any evidence of peritoneal irritation. Full attention should be paid to progressive diarrhea in patients with malignancies during anticancer chemotherapy.
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PMID:Induction of diffuse necrotizing enterocolitis by anticancer chemotherapy. 362 12

Necrotizing enterocolitis is an uncommon but dangerous disease in premature infants. Ten cases, seen over a three-year period at the Stanford University Medical Center, represented an incidence of 0.4 percent. The patients, six of whom died, derived from a general population, in contrast to the large series of patients reported in the literature in which the incidence was from 0.9 percent to 3.7 percent.(3-6)The initial symptoms-rapid respiration, periodic breathing, lethargy and irritability-were identical to those which occurred in numerous infants who had respiratory disease. Subsequent symptoms (abdominal distension, in 100 percent; vomiting, 80 percent; apneic spells, 70 percent; jaundice, 70 percent; guaic-positive stools, 60 percent) were those of nonspecific acute abdominal disease. The radiologist first made the diagnosis in 90 percent of cases. Interstitial air in the wall of the gut and the retroperitoneum, and portal vein gas were the most diagnostic radiographic features. Barium contrast studies were not helpful, and in one case led to the erroneous diagnosis of small bowel volvulus. Plain abdominal radiographs must be taken of all premature infants with symptoms of nonspecific acute abdominal disease. If the radiographs are negative, but symptoms continue, they should be repeated at frequent intervals, for early diagnosis is critical to institution of proper therapy.
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PMID:Neonatal necrotizing enterocolitis. Clinical and radiological features. 481 93

Forty-six cases of necrotizing enterocolitis were seen at the Baudelocque maternity hospital from august 1978 to october 1980. In eighteen cases, clinical signs associated with roentgenograms showing pneumatosis led to unequivocal diagnosis. A surgical procedure was done in nine of these patients, during the acute stage in four and later on in five. Diagnosis was strongly suspected in twenty-eight cases. Clinical features were less serious and included abdominal distension, bloody stools, and emesis. There were no roentgenological signs. None of these infants underwent surgery. Overall mortality rate was 7% (3/46). In comparison to previously published studies, our series shows lower perinatal risk factors, higher mean birthweight, and lower prematurity rate (14%). No evidence was found to support the responsibility of a specific bacterial agent. Corona virus was found in the stools of five out of eleven cases studied during the second epidemic wave in october 1979, suggesting a possible viral etiology. Several preventive steps have been taken. Breast-feeding has been encouraged. Each mother-infant pair has been isolated instead of grouping infants in night nurseries. Staff members have been given specific information on the means of preventing contamination.
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PMID:[Necrotizing enterocolitis. A study of forty-six cases seen in a maternity hospital]. 629 79

In a random, controlled study of very low birth weight (VLBW) infants from 3 to 8 weeks of age, 17 infants were fed soy isolate formula supplemented with calcium (92 mg/kg/day), phosphorus (44 mg/kg/day), and vitamin D (500 IU/kg/day), and 15 were fed a new whey-predominant, low osmolality formula designed for small preterm infants. Mean birth weight (1,206 g, SD 178) and gestational age (30 weeks, SD 1.9) of the soy-fed group were not significantly different from the whey formula group (1,143 g, SD 158, and 30 weeks, SD 1.8, respectively). Caloric and protein intakes were not different between the formula groups throughout the study period. However, mean weight gain in g/kg/day was significantly greater for the whey formula group: 15.3 g, SD 2.5, vs. 11.3 g, SD 2.3, p less than 0.0001. Serum protein and albumin were higher in the whey formula-fed group during the latter 2 weeks of the study (p less than 0.05). The incidence of vomiting, gastric residual, abdominal distension, diarrhea, and constipation was low and not different between the two groups. No infant developed necrotizing enterocolitis. Serum calcium, phosphorus, alkaline phosphatase, 25-hydroxy vitamin D and parathyroid hormone were similar in both groups, and no infant developed radiographic evidence of rickets. Although soy isolate formula supplemented with calcium, phosphorus, and vitamin D was not associated with rickets, no fewer complications were observed with this lactose-free, low solute formula.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of calcium- and phosphorus-supplemented soy isolate formula with whey-predominant premature formula in very low birth weight infants. 633 95

Hirschsprung's disease has become a more common cause of newborn intestinal obstruction in the past 30 years. In a group of 137 newborns with intestinal obstruction the most common diagnosis was necrotizing enterocolitis. The second most common cause, however, was Hirschsprung's disease. We have reviewed 26 infants with aganglionosis who presented at 32 days of age or less between 1972 and 1978. The average age at presentation was 8.3 days. There were 21 males and five females. Five infants had long-segment or total colonic disease. There was only one premature infant (34 weeks, 1840 g). The mean birthweight in the series was 3.6 kg. Six children had a family history of a congenital anomaly (23%). Three of these had a family history of Hirschsprung's disease (12%). Nine infants (35%) had associated congenital anomalies. Four of these newborns had Down's syndrome, and all four had a cardiac anomaly as well. Fifteen newborns presented with emesis (58%) which was bilious in nine (35%) cases. Seventeen babies (65%) had abdominal distension at the time of presentation. Eleven infants passed a meconium stool by 24 hours of age (42%), and 15 had passed meconium by 48 hours (58%). Twenty-two of 24 (92%) barium enema examinations available prior to diagnosis were diagnostic of Hirschsprung's disease. All of the 23 suction rectal biopsies were positive. All 26 patients underwent a colostomy or ileostomy following diagnosis. There was no enterocolitis and no mortality. All 26 patients have had an endorectal pullthrough performed at a mean age of 11.8 months without major complications.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hirschsprung's disease in the newborn. 648 80

Cases of formula protein intolerance (FPI), in which many of the features of neonatal necrotizing enterocolitis (NEC) have been exhibited (vomiting, diarrhea, hematochezia, abdominal distention, and pneumatosis intestinalis), have been reported (1-6). This case of combined cow's milk and soy protein intolerance illustrates further the difficulty in distinguishing clinically between NEC and FPI. Moreover, it demonstrates that intestinal stricture is a potential long-term complication of FPI, as it is also of NEC, and suggests that significant morbidity may result when the diagnosis of FPI is not considered as a cause of the NEC syndrome.
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PMID:Colonic stricture complicating formula protein intolerance enterocolitis. 688 45


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