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

The rate of postoperative recovery is determined by pain, stress-induced organ dysfunction, and limitations in conventional postoperative care. We attempted to provide "stress-free" colonic resection for neoplastic disease in eight elderly high-risk patients by a combination of laparoscopically assisted surgery, epidural analgesia, and early oral nutrition and mobilisation. Effective pain relief allowed early mobilisation, and hospital stay was reduced to 2 days without nausea, vomiting, or ileus. Postoperative fatigue and impairment in functional activity were avoided. Major advances in postoperative recovery can be achieved by early aggressive perioperative care in elderly high-risk patients undergoing colonic surgery.
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PMID:Recovery after laparoscopic colonic surgery with epidural analgesia, and early oral nutrition and mobilisation. 789 89

In this retrospective study carried out covering the period, 1978-1991, 62 neonates were seen, diagnosed and treated for intestinal atresia which included: duodenal atresia and stenosis, small bowel atresia and atresia of large bowel. Locations of obstruction were duodenal in 17 patients, jejunal in 25 patients, jejuno-ileal in 5 and colon in two. Duodenal atresia was noted in 9 infants and duodenal stenosis due to annular pancreas, Ladd's bands with malrotation of bowel in 8. Associated anomalies which were observed were anorectal malformations in 2 and malrotation in 2 infants. Birth weights ranged from 1450 gm to 3000 gm. Prematurity was recorded in 11 infants. Diagnosis of intestinal atresia in our patients was made clinically and radiologically. Intestinal atresia in neonates was differentiated from other causes of obstruction such as Meconium Ileus, Hirschsprung's disease, neonatal volvulus, rectal atresia in anorectal malformations. Treatment of infants with intestinal atresia was surgical. Surgical techniques used depended on pathological findings. In 36 patients, complications such as functional obstructions with vomiting and failure to thrive, malabsorption, aspiration, bronchopneumonia, sepsis were observed. Overall mortality rate in our cases was 25 (41.9%) out of 62 patients.
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PMID:Intestinal atresia and stenosis as seen and treated at Kenyatta National Hospital, Nairobi. 818 36

Meconium ileus was noted as an early manifestation of cystic fibrosis in 60 neonates between 1972 and 1991. There were 20 girls and 40 boys. A family history of cystic fibrosis was present in six children. Twenty-five neonates had uncomplicated meconium ileus due to inspissated meconium within the terminal ileum. Thirty-five neonates presented with 56 complications of meconium ileus, including volvulus (n = 22), atresia (n = 20), perforation (n = 6), and giant cystic meconium peritonitis (n = 8). Clinical presentation included abdominal distension, bilious vomiting, and failure to pass meconium. In two recent cases, prenatal ultrasonography detected a mass with proximal bowel distension indicative of cystic meconium peritonitis. Mechanical bowel obstruction in the other neonates was diagnosed from plain abdominal radiographs and barium enema. Ten patients with uncomplicated meconium ileus were successfully treated with a diatrizoate meglumine (Gastrografin) enema. The remaining 15 patients required a laparotomy, with 9 treated by bowel resection and enterostomy and 6 recent cases managed with enterotomy and irrigation. Complicated cases were managed by bowel resection and anastomosis (n = 15) or enterostomy (n = 20). Survival at 1 year was 92% in patients with uncomplicated meconium ileus and 89% for those with complicated meconium ileus. The therapy of choice for uncomplicated meconium ileus is nonoperative Gastrografin enema, with enterotomy and irrigation reserved for enema failures. Complicated cases require exploration and, in the absence of giant cystic meconium peritonitis, are usually amenable to bowel resection and primary anastomosis.
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PMID:Contemporary management of meconium ileus. 833 77

A 65-year-old Japanese male, who was treated for Fournier's gangrene, developed an enlarged erythema over the right thigh and right lower quadrant. The area was surgically debrided, and he was given antibiotics. However, he complained of abdominal swelling with a metallic bowel sound, pain, and vomiting and was then treated for paralytic ileus. Although his symptoms initially improved, he complained again of the same symptoms and underwent surgery for mechanical ileus occurring at the site of a surgical scar from an appendectomy 43 years earlier. This is a very rare case of Fournier's gangrene which caused mechanical ileus of the small intestine and adherence to a peritoneal scare after paralytic ileus due to inflammation of the abdominal fascia following scrotal gangrene.
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PMID:Fournier's gangrene: report of a case associated with paralytic and mechanical ileus throughout the management of the gangrene. 840 25

We studied ten cases with abdominal pain after eating raw firefly squid, Watasenia scintillans, Hotaruika. Characteristic clinical features were abdominal pain, nausea, vomiting, diarrhea, creeping eruption and ileus with ascites. In ten patients, there were all cases with abdominal pain, nine with nausea and vomiting, four with diarrhea, one with creeping eruption, six with ileus. Laboratory examination revealed eosinophilia on peripheral blood in ten cases and high serum IgE value in nine cases. The infection rate of type X lavae of the suborder spirurina in Watasenia scintillans is almost 3%, so we measured the antibody to type X larvae of the suborder spirurina in nine patients by indirect fluorescent antibody method and the antibody titer was positive in seven cases. Most patients recovered in several days from first visit. But one patient was diagnosed peritonitis and operated with partial ileectomy. Pathological finding of resected specimen showed an erosion in the mucosal layer and an inflammation with marked eosinophilia in the submucosal layer. These results suggest that abdominal complaints after eating Watasenia scintillans are due to type X larvae of the suborder spirurina.
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PMID:[Clinical study of ten cases with acute abdomen after eating raw firefly squid (Watasenia scintillans, Hotaruika), which are probably due to type X larvae of the suborder spirurina]. 864 68

We report a case in which rectal obstruction due to prostate cancer was exacerbated due to an ileus after the administration of luteinizing hormone-releasing hormone analogue. The obstruction to led to copious vomiting, dehydration and renal failure which necessitated hemodialysis. Improvement of the patient was noted four weeks after the start of hormonal treatment with a decrease in rectal obstruction concomitant with decreases in testosterone and prostate specific antigen levels.
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PMID:Acute renal failure in a patient with chronic glomerulonephritis after the administration of luteinizing hormone-releasing hormone analogue given for rectal obstruction due to prostate cancer. 864 4

A 27-year-old man was admitted to our hospital because of abdominal pain and vomiting. A radiograph of the chest revealed widening of the right superior part of the mediastinum, and an abdominal radiograph showed many air-fluid levels. A computed tomographic scan of the chest revealed a solitary nodule in the right anterior lobe of the lung, and right paratracheal lymphadenopathy. Ileus was diagnosed and a nasogastric tube was inserted. The patient's condition gradually worsened, and on hospital day 17 a laparotomy was performed. Operative findings were significant for numerous, white nodules all over the peritoneum, omentum, and mesentery, which ranged from miliary to rice grain-sized. Examination of an omental specimen revealed noncaseating granulomas with Lang hans' giant cells. The polymerase chain reaction was used to examine fluid from the nasogastric tube used before surgery, and on hospital day 40 that fluid was found to be positive for Mycobacterium tuberculosis. M. tuberculosis was also cultured from the fluid. From these findings, we concluded that this was a case of pulmonary tuberculosis manifesting predominantly as ileus secondary to tuberculous peritonitis. Anti-tuberculosis therapy consisting of isoniazid, rifampin, and ethambutol was started postoperatively. On repeat laparoscopy 224 days later, no white nodules were seen. A computed tomographic scan of the chest revealed that the right paratracheal lymphadenopathy was markedly reduced, and the solitary nodule in the right anterior lobe of the lung was almost gone. Few cases of young people with pulmonary tuberculosis manifesting primarily as ileus have been reported. Tuberculosis should be included in the differential diagnosis in patients presenting with ileus.
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PMID:[Pulmonary tuberculosis manifesting predominantly as ileus secondary to peritoneal tuberculosis in a young man]. 869 74

A blue-and-gold macaw (Ara ararauna) was presented with a history of vomiting and production of small amounts of thin feces. A diagnosis of partial obstructive ileus was made following an oral barium-contrast study of the alimentary canal. The ileus proved to be the result of an adhesion of an intestinal loop to the abdominal wall and was successfully corrected by surgical intervention.
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PMID:Surgical correction of ileus in a blue-and-gold macaw (Ara ararauna). 879 Sep 5

A 4-month-old male infant was admitted to our hospital because of poor intake and mild abdominal distention for 1 day. Fever and watery diarrhea had occurred 4 days prior to admission, but subsided 2 days later after taking oral medications. A physical examination showed an acute ill-looking baby with a soft and mildly distended abdomen. The bowel sound was hypoactive and no obvious abdominal tenderness was found. Normal leukocyte and differential counts were noted in initial laboratory examinations; however, the serum level of C reactive protein was extremely high (31.4 mg/dL). Progressive abdominal distention and bilious vomiting occurred. Serial plain films of abdomen showed ileus with a fixed gas pattern and an abdominal echo revealed intraperitoneal fluid accumulation. Under the impression of intestinal perforation, an emergency laparotomy was performed. A perforated appendicitis with turbid fluid in the peritoneal cavity was noted during surgery. A pus culture grew Pseudomonas aeruginosa which was sensitive to Ceftazidime only. Triple antibiotics consisting of Prostaphlin, Metronidazole, and Ceftazidime were administered for 2 weeks. The patient was discharged 3 weeks later without any complications. Appendicitis in infancy is a rare condition and associated with a high frequency of perforation and peritonitis. Diagnosis is often difficult because of variable and nonspecific clinical manifestations.
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PMID:Perforated appendicitis in a 4-month-old infant. 885 51

The authors have carried out a prospective trial to assess the safety, tolerability and outcome of early resumption of oral feeding after elective abdominal surgery involving the small or the large bowel. Over the study period, 161 patients undergoing elective laparotomy and bowel resection were randomized to two groups. Patients undergoing laparoscopic surgery were not included. In both groups, the nasogastric tube was removed immediately after surgery. In group I, oral feeding was started on first postoperative day, beginning with clear fluids and gradually progressing to a normal diet over a period of 24 to 48 hours, as tolerated. In group II, oral feeding was started after resolution of postoperative ileus, starting again with clear fluids as in group I. The resolution of postoperative ileus was defined as having bowel movements with no abdominal distention or vomiting. In both groups, nasogastric tube was reinserted if the patient had two episodes of vomiting of more than 100 ml over 24 hours in the absence of bowel movements. Postoperative analgesia was similar in both groups and same criteria for discharge from the hospital were followed. Of the 161 patients, 80 were in the early feeding group and 81 in the other group. The age and sex distribution of the patients in both groups was similar. In both groups, segmental colonic, rectal or small bowel resection was the commonest surgery. In group I, 79% patients tolerated feeds compared to 86% in group II. The incidence of vomiting was thus 21% in group I and 14% in group II, the difference being statistically insignificant. Reinsertion of nasogastric tube was required only in 11% patients in group I and 10% patients in group II. Further, the length of postoperative ileus (3.8 + 0.1 vs 4.1 + 0.1 days), length of hospital stay (6.2 + 0.2 vs 6.8 + 0.2 days) and incidence of complications (7.5% vs 6.1%) were not significantly different between the two groups. However, regular diet was tolerated significantly earlier. (p <0.001) in group I as compared to group II (2.6 + 0.1 vs. 5.0 + 0.1 days). Further, there was no incidence of anastomotic leaks or aspiration pneumonia, complications which could be expected to occur secondary to early feeding. The authors have reviewed the literature which shows a trend towards decreasing use of routine postoperative nasogastric drainage. Based on the results of the current study, they suggest that there is no need to delay oral feeding till resolution of colonic ileus as early feeding is safe and well tolerated. They also suggest that early resumption of oral feeding may have a positive impact on the psychological state of the patient and may help the recovery.
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PMID:Early oral feeding after elective colorectal surgery: is it safe. 885 62


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