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

Alimentary tract manifestations were found in all of 17 patients with multiple endocrine neoplasia, type 2b. The manifestations are important because (1) they were chronic, (2) they were severe and led to abdominal operation in 5 patients, (3) they antedated detection of the endocrine neoplasms in the syndrome in 16 patients (94%), and (4) they provided clinical clues that stimulated search for thyroidal C-cell and adrenal medullary disease in 6 patients. The alimentary tract manifestations were diverse: symptoms included constipation, diarrhea, difficulty with feeding, projectile vomiting, crampy abdominal pain, and loud borborygmi; findings included thickened lips, nodules on the anterior third of the tongue, abdominal distention, visible peristaltic waves, and roentgenographic evidence of megacolon or diverticulosis of the colon or of dilatation of the small intestine and stomach. Initial misinterpretation or failure to realize the significance of one or more of these alimentary tract manifestations led to suspicion of aganglionic megacolon (three patients), malabsorption syndrome (two patients), and tracheal ring (one patient).
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PMID:Alimentary tract manifestations of multiple endocrine neoplasia, type 2b. 89 96

This paper presents in detail the symptomatology and findings on examination of 642 patients suffering from a variety of lower gastrointestinal disorders, such as colonic and rectal cancer, diverticular disease, Crohn's disease, and ulcerative colitis. Location of precise sites of abdominal pain and tenderness was shown to carry a high level of diagnostic discrimination between the various disorders. Some surprising features emerged: almost half of patients with lower gastrointestinal tract disease complained of symptoms referable to the upper gastrointestinal tract, such as nausea/vomiting or anorexia. It is suggested that the provision on demand of such data to junior staff may benefit both diagnostic ability and decision making. As an incidental finding, just under 40% of patients with large bowel cancer had undergone previous (unrelated) abdominal surgery. The significance of this is unclear.
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PMID:Clinical presentation of diseases of the large bowel. A detailed study of 642 patients. 124 82

One observation of total colon diverticulosis in a male of 62 is described. Clinical signs (abdominal pains, blood in faeces, vomiting) persisted for 7 years and was aggravated by ileus. Instrumental examination revealed multiple colon diverticula, stenosing villous tumour of sigmoid colon. Besides pseudodiverticula, chronic colitis with multiple inflammatory polyps stenosing the lumen of the sigmoid colon and simulating a villous tumour was found. The conclusion is made of the ischemic nature of the colitis complicating the course of diverticulosis.
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PMID:[Total diverticulosis of the large intestine, complicated by ischemic colitis with development of multiple inflammatory polyps]. 208 75

A retrospective review was carried out of 148 consecutive personal truncal vagotomies and anterior pylorectomies (TV + P), median follow-up 5.0 years. The recurrent ulcer rate was 6/148 (4.1%) for suspected (SRU) and 5/148 (3.4%) for proven ones (RU). This led to one death from RU. Thirty-six patients (24.3%) developed postvagotomy diarrhoea (PVD). Two of these were graded Visick IV because their occupations made PVD particularly inconvenient. These results are similar to those for TV and pyloroplasty, despite the slightly more destructive nature of pylorectomy. There were nine patients in whom evidence of associated bowel disease had been documented before or during operation. The occurrence of such evidence was significantly more frequent in the PVD group (6/36 vs. 3/112 patients, P = 0.014), suggesting either a summation of effects due to the bowel disease and the operation or that the diagnosis of PVD was sometimes incorrect. Of the six in the PVD group, two were in Visick Grade II because of their PVD, and four in Visick grade III or IV, but in one of these SRU was the main cause of the poor result, and in two the PVD was subsidiary to vomiting or dumping. One further patient in Visick III due to PVD had diverticular disease diagnosed after operation. Thus there were identifiable factors (occupation, associated bowel disorder) which could have been used to predict seven of the unsatisfactory results due partly or completely to PVD. TV + P is an effective operation for duodenal ulcer but, as with TV + pyloroplasty (though to no greater an extent), severe diarrhoea may occasionally mar the result.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Towards selecting the vagotomy and avoiding diarrhoea. 234 1

The characteristics and the prevalence of functional bowel disorders in the general French population are unknown. Based on an epidemiological inquiry in a random population of 1,200 persons who were not seeking care, residents in our country we established: the prevalence of symptoms suggestive of functional bowel disorders; the epidemiological differences between symptomatic subgroups which included abdominal pain with or without bowel dysfunction, diarrhea and constipation. The amount of cases and the prevalence in each subgroup were: abdominal pain, 165, 13.8 p. 100, painless constipation, 75, 6.3 p. 100, diarrhea, 10, 0.8 p. 100. As a whole, functional bowel disorders occurred in 20 p. 100 of our population. The "irritable bowel syndrome" group defined as abdominal pain and/or diarrhea differ from normal subjects by the following higher frequency of age under 50, subjects in active duty, antecedents of diverticulosis, influence of stress on symptoms, nausea, vomiting, migraines, pyrosis and number of visits to a doctor. However neither the sex-ratio nor professional occupation were relevant. The constipation group differed from normal because of the higher frequency of female sex, antecedents of hiatus hernia, use of laxatives but not because of age nor by the number of associated symptoms. In conclusion, functional bowel disorders occurred in 20 p. 100 of our population; two subgroups were clearly different from an epidemiological point of view, the irritable bowel syndrome (13 p. 100) and constipation (7 p. 100); therefore these two groups deserve a specific physiopathological, psychological and therapeutic approach.
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PMID:[Epidemiology of intestinal functional disorders in an apparently healthy population]. 395 14

Fifty-eight patients with uncomplicated diverticular disease of the colon took bran crispbread, ispaghula drink, and placebo for four months each in a randomised, cross-over, double-blind controlled trial. Assessments were made subjectively, using a monthly self-administered questionnaire, and objectively, by examining a seven-day stool collection at the end of each treatment period. In terms of a pain score, lower bowel symptom score (the pain score and sensation of incomplete emptying, straining, stool consistency, flatus, and aperients taken), and total symptom score (belching, nausea, vomiting, dyspepsia, and abdominal distension) fibre supplementation conferred no benefit. Symptoms of constipation, however, when assessed alone, were significantly relieved. Both fibre regimens produced the expected changes in stool weight, consistency, and frequency. It is concluded that dietary fibre supplements in the commonly used doses do no more than relieve constipation. Perhaps the impression that fibre helps diverticular disease is simply a manifestation of Western civilisation's obsession with the need for regular frequent defecation.
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PMID:Are fibre supplements really necessary in diverticular disease of the colon? A controlled clinical trial. 626 96

Jejunal diverticulosis is an uncommon condition, but it is often associated with a number of symptoms including postprandial abdominal pain, distension, flatulence, borborygmus, nausea, vomiting, diarrhea and constipation and with complications such as vomiting blood or coffee grounds material, melena and shock. The authors report such a condition in a 71-year-old man. Resection is the treatment of choice for relieving symptoms, and for preventing or treating complications.
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PMID:Jejunal diverticulosis. 676 77

Twenty-seven cases of chronic intestinal pseudo-obstruction are reported. The causes of pseudo-obstruction were progressive systemic sclerosis in 14, hollow visceral myopathy in 4, visceral neuropathy in 2, sclerosing mesenteritis in 1, and jejunal diverticulosis in 1. No identifiable cause was found in five. Chronic pseudo-obstruction is a long-term illness characterized by vomiting, abdominal distention, abdominal pain and weight loss. Involvement is often present throughout the intestine so that patients may present with a variety of symptoms deriving from the esophagus, stomach, small intestine, and colon. Hollow visceral myopathy and visceral neuropathy are usually familial and urologic involvement is sometimes present in the former. Abnormalities of smooth muscle function can be discerned by radiography and esophageal manometry. The pattern and distribution of the abnormalities are helpful in differentiating pseudo-obstruction from true mechanical obstruction. They may also be helpful in differentiating one form of pseudo-obstruction from another. The majority of cases have identifiable pathology within either the smooth muscle or myenteric plexus of the bowel wall. The natural history of pseudo-obstruction is variable. Remissions and exacerbations occur and may be unrelated to anything that is done therapeutically. The illness is unresponsive to any drug known to have an effect on intestinal motility. Antibiotic treatment of small intestinal bacterial overgrowth and selected surgical procedures may occasionally be palliative. Many patients develop malnutrition and require home parenteral nutrition in order to survive.
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PMID:Chronic intestinal pseudo-obstruction. A report of 27 cases and review of the literature. 689 76

Duodenal diverticulosis is not a rare condition. Usually of little clinical significance, it can produce a variety of disorders such as malabsorption, hemorrhage, diverticulitis, and obstruction. The rarest complication appears to be enterolith formation and obstruction. The case presented is a 70-year-old woman with the chief complaints of intermittent abdominal pain and vomiting. At laparotomy, duodenal diverticulitis and one enterolith obstructing the distal ileum were found. The literature review presents the other 26 cases with small bowel obstruction due to an enterolith formed within a small bowel diverticulum. The diagnosis can be established only by documenting the normalcy of the gallbladder and the presence of duodenal or jejunal diverticula.
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PMID:Enterolith ileus as a complication of duodenal diverticulosis--one case report and review of the literature. 823 Mar 70

We herein present a patient with lipomatosis of the ileum including diverticulosis and volvulus. The patient presented with abdominal pain and vomiting. Preoperatively, we diagnosed lipomatosis with volvulus of the ileum based on the findings of abdominal ultrasonography (US) and computed tomography (CT). During surgery, the dilated ileum had rotated 720 degrees counterclockwise, and was found to contain lipomatosis and multiple diverticula. Although lipomatosis of the small bowel is extremely rare, it does show characteristic US and CT findings, thus making a preoperative diagnosis possible if this disease is included in the differential diagnosis.
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PMID:Lipomatosis of the ileum with volvulus: report of a case. 968 15


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