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

Persistent vomiting, diarrhoea, or intolerance of feeding, are well recognised problems in children after surgical correction of intestinal malrotation. Conversely, intestinal malrotation is a common accompaniment of chronic idiopathic intestinal pseudo-obstruction. We investigated motor activity of the small intestine during fasting in eight children who had persistent vomiting, intolerance of full enteral feeding, or severe diarrhoea after surgical correction of intestinal malrotation. Abnormality of motor function similar to that found in neuropathic pseudo-obstruction was found in seven of the eight patients. Persistence of symptoms after surgical correction of a malrotation is associated with a motility disturbance which seems to be due to a defect of intrinsic enteric innervation. Such a defect may be important in the aetiology of the malrotation.
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PMID:Persistent gastrointestinal symptoms after correction of malrotation. 154 83

The study of 325 patients who underwent gastric partitioning (stapling) was undertaken to assess the complications and weight-loss records over a 5-year period. A subgroup of 15 patients was studied to determine protein status preoperatively and 2, 4, and 6 months after surgery. Laboratory tests, anthropometric measures, and food records were used to assess patient health and nutritional status. Four operative techniques have been used by a surgeon in Reno, NV, since 1979. The main postoperative complication in the first two procedures, a nonreinforced horizontal staple line (Groups 1 and 2), was staple line disruption and, therefore, poor weight-loss results. The staple line was reinforced in the next 193 patients (Group 3), and the patients followed a blenderized diet for 8 weeks postoperatively. Persistent vomiting was the most common problem in that group; 24% required dilatation of the stoma via gastroscopy. The vertical staple procedure was adopted for the next 48 patients (Group 4) to further minimize disruption and severe vomiting. Other operative complications were relatively few. At 48 and 18 months, respectively, Groups 3 and 4 showed an average weight loss of 27% of the preoperative weight. Eating patterns and food tolerances changed dramatically postoperatively, and protein intake dropped significantly. Mean protein intakes below standard recommended dietary allowance (RDA) were observed in a subgroup of Groups 3 and 4. However, the mean total lymphocyte count and albumin values demonstrated that patients were not compromising visceral proteins. The mean creatinine height indexes and arm muscle areas showed no significant difference in somatic protein status.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Gastric partitioning for morbid obesity: postoperative weight loss, technical complications, and protein status. 370 Sep 25

In a feeding trial 66 infants of low birth weight received continuous intragastric milk feeds from the fourth hour of life, starting with 60 ml/kg/24 hr and reaching a maximum of 300 ml/kg/24 hr on the ninth day. Each infant received only full-strength milk, which was either expressed human breast milk or SMA-S26 (a proprietary low-protein adapted cows' milk) or half-cream Regal milk (partly-skimmed evaporated cows' milk). For various reasons 10 babies had to be withdrawn, and the final assessment was made on the 56 who completed the trial successfully.Persistent vomiting was a problem in only four infants. In two of them the trial was continued after gastric lavage and in the other two vomiting stopped when the volume was reduced. Despite a careful search no evidence was found of aspiration of feeds in any infant. Continuous intragastric milk infusion was shown to be a safe method of feeding infants of low birth weight and SMA-S26 was almost as well tolerated as human milk. Because of the high-protein content of half-cream cows' milk preparations and the resultant high plasma amino-acid levels when they are given in these large volumes they should be avoided for this type of feeding although they produce better weight gains in the first week of life.
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PMID:Continuous intragastric milk feeds in infants of low birth weight. 462 50

Vomiting is a considerable problem among severely retarded individuals. The majority have gastroesophageal reflux (GER). The incidence is increased in those who are nonambulatory or have scoliosis and/or spastic quadriplegia. In the absence of other symptoms, these persons should be kept in the upright position as much as possible. Persistent vomiting warrants a roentgenographic examination of the upper gastrointestinal tract. If GER is the only finding, upright positioning should be continued. The occurrence of complications attributable to GER is an indication for further diagnostic evaluation.
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PMID:A diagnostic approach to vomiting in severely retarded patients. 682 24

Nausea and vomiting are common problems of pregnancy. Three pregnant women, 27, 25 and 28 years of age, presented with vomiting in the third trimester. The causes appeared to be maternal small bowel volvulus, which was derotated after primary caesarean section, an ileocecal abscess, which was the first manifestation of Crohn's disease, and acute pyelonephritis, treated with cefuroxim. The second and third babies were born spontaneously; no maternal or foetal mortality occurred. Persistent vomiting after the first trimester of pregnancy should be considered an alarm symptom which always requires further investigation.
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PMID:[Vomiting after the first trimester of pregnancy: an alarming symptom]. 964 5

Persistent vomiting after pyloromyotomy is rare. We report the case of a boy with recurrent vomiting after a successful pyloromyotomy, who required repyloromyotomy.
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PMID:Recurrent vomiting after successful pyloromyotomy. 1241 14

Acute nausea and vomiting are often self-limited or easily treated. Persistent vomiting, however, poses diagnostic and therapeutic challenges for the primary care physician. In addition to gastrointestinal, neurologic, and endocrine disorders, the differential diagnosis includes psychiatric illnesses, such as eating and factitious disorders. We present the case of a 52-year-old woman referred to the Tulane University Internal Medicine/Psychiatry clinic with persistent daily vomiting for 8 years despite repeated medical evaluations. The vomiting was of sufficient severity to require intensive care unit admission for hematemesis. A dually trained internal medicine-psychiatry house officer obtained further history and identified that the woman experienced an intrusive thought that urged her to vomit after each meal. Resisting the urge resulted in intolerable anxiety that was relieved only by vomiting. Obsessive-compulsive disorder (OCD) was diagnosed according to DSM-IV criteria. Initiation of escitalopram with titration to clinical response resulted in full symptom resolution and meaningful quality of life improvement. Pertinent literature was reviewed using 2 methods: (1) an English-language MEDLINE search (1966-February 2004) using the search terms vomiting and (chronicor psychogenicor psychiatric), and obsessive-compulsive disorder and (primary care or treatment); and (2) a direct search of reference lists of pertinent journal articles. A review of psychiatric etiologies of vomiting and primary care aspects of OCD is presented. Primary care clinicians are strongly encouraged to consider psychiatric etiologies, including OCD, when common symptoms persist or present in atypical ways. Such disorders can be debilitating but also responsive to treatment.
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PMID:A Somatoform Variant of Obsessive-Compulsive Disorder: A Case Report of OCD Presenting With Persistent Vomiting. 1551 88

In order to document the incidence of perioperative complications in patients with infantile hypertrophic pyloric stenosis, a descriptive cohort study was performed in two teaching hospitals in the Netherlands. One hospital specialized in pediatric surgery and the other was a general surgery teaching hospital. All consecutive infants who underwent pyloromyotomy for the diagnosis hypertrophic pyloric stenosis in both hospitals between 1998 and 2002 were included. The children were diagnosed and treated according to a standard protocol. From all charts, complications durante- and post-operationem were recorded. A total of 256 pyloromyotomies were performed. Registered perioperative complications were duodenal mucosal perforation (n=6; 2%). Perioperatively unrecognized duodenal mucosal perforation occurred four times (1%). One re-operation was performed for an incomplete pyloromyotomy (0.3%). Persistent vomiting after the operation occurred in 18 children (7%). A large majority of postoperative complications were wound infections (n=16; 6%), 12 after right upper quadrant incision and 4 after umbilical incision; most of them were treated with antibiotics and/or incision for drainage of an abscess. An incisional hernia occurred four times. Prolonged vomiting was the only postoperative complication that differed significantly between the two teaching hospitals. The overall percentages of complications were equal to complication rates in literature, and since there were no extensive differences in major complications between the two teaching hospitals in this study, we can conclude that pyloromyotomy can be performed safely in specialized centers and in general centers provided with a multidisciplinary team.
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PMID:Can pyloromyotomy for infantile hypertrophic pyloric stenosis be performed in any hospital? Results from two teaching hospitals. 1697 35

Vomiting is a physical finding that can occur at any age but presents the greatest challenge when it is recurrent in a child. The etiology is varied (Sieunarine and Manmohansingh, 1989; Suzuki, 1982), and recurrent vomiting can be a symptom of life threatening medical or surgical emergencies. Early recognition is mandatory for preventing delay in management and potential complications. Gastric duplication is rare and mostly diagnosed in infancy with only a few cases documented in the medical literature presenting in childhood. We present a three-year-old Vietnamese female with recurrent vomiting. Obstruction and sepsis were ruled out as a cause of the recurrent vomiting by history and appropriate tests. Persistent vomiting and paucity of air on the plain abdominal films provided a clue to the diagnosis. A CT scan of the abdomen with contrast revealed a uniformly thin walled fluid attenuation mass in the epigastric region which did not opacify with contrast. An abdominal ultrasound confirmed gastric duplication cyst and the patient was taken to the operating room for excision of the cyst.
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PMID:Gastric Duplication: A Rare Cause of Recurrent Vomiting. 2833 53