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

As part of a continuing audit of patients undergoing laparoscopic cholecystectomy (which now numbers over 1500) 468 of the 508 patients (92.1 per cent) operated on between October 1989 and March 1991 were studied between 350 and 988 days after the operation (mean 19 months). A questionnaire was filled in by each patient before operation and at the late follow-up visit. Eight specific symptoms were sought-non-colicky pain, colic, abdominal distension, nausea, vomiting, loss of appetite, flatulence, and dietary restriction. The result of each operation was assessed by two surgeons and by the patient. In 453 patients (96.8 per cent) the symptoms had improved as a result of the operation, but 260 patients (55.6 per cent) had some abdominal symptoms. The result was assessed as excellent in 310 patients (66.2 per cent); 143 (30.5 per cent) still had abdominal complaints but they were willing to cope with those symptoms. In 15 patients (3.2 per cent) the result was unsatisfactory. Statistical analysis of 26 preoperative variables showed few significant differences between patients with excellent results and patients with persisting or new symptoms. The percentage of patients with biliary colic was reduced from 82.9 per cent before to 6.4 per cent after laparoscopic cholecystectomy (P < 0.05), and of those with flatulence from 62.6 per cent to 45.3 per cent (P < 0.05). Flatulence persisted in 147 (50.2 per cent) of the 293 patients who had complained of flatulence before the operation, and of the 175 patients who had not complained of flatulence before surgery, 65 (37.1 per cent) reported the symptom for the first time after the operation. It appears that 'flatulent dyspepsia' after cholecystectomy has many causes, one of which may be removal of the gallbladder. It is concluded that the long-term results of laparoscopic cholecystectomy in patients with symptomatic gallstone disease were excellent but the prognosis in individual patients was unpredictable.
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PMID:Long-term results after laparoscopic cholecystectomy. 774 8

Intussusception is commonly the etiology of intestinal obstruction in infants and children. To investigate demographic data, clinicopathologic features and therapeutic prognosis of patients with intussusception, we reviewed 361 intussusceptions in 333 patients over an 11-year period. Most patients were below two years of age and there was a male preponderance of 1.6:1. There was no seasonal difference between the number of cases. The clinical triad of vomiting, abdominal colicky pain and bloody stools was manifested in only one-third of our patients. Secondary intussusception contributed to 6.6% of cases and Meckel's diverticulum was the most common pathologic cause. Positive findings were recorded in 82% of 67 patients undergoing sonographic examination. Intussusception of the ileo-colic type was most frequently encountered. Most patients (79%) were diagnosed within 48 hours and almost all cases underwent primary barium enema reduction. The success rate was 45%. Laparotomy was performed in 207 patients (57%) refractory to enema reduction or with critical illness, and intestinal resection was required in 28 (14%). Long-standing duration of illness (> 24 hours), positive clinical triad, positive pathologic lead point, and radiologic finding of bowel obstruction were identified as risk factors leading patients to surgical reduction (p < 0.001). Postoperative complications and recurrent intussusception developed in some patients, and the overall mortality was 0.6%. The clinical characteristics of intussusception in children generally remained unchanged as compared to previous reports. Early identification of patients with risk factors for surgical treatment is important to decrease the need for intestinal resection.
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PMID:Intussusception in infants and children: risk factors leading to surgical reduction. 785 36

A structured questionnaire was sent to the parents of 120 children from a cohort 192, who had undergone a pyloromyotomy for pyloric stenosis at Westmead Hospital during the years 1984-91. Information was gained from 85 children in 82 families regarding gastrointestinal complaints and family history of pyloric stenosis. There were few gastrointestinal problems, no reports of recurrent abdominal pain, but two reports of clinically significant vomiting (2.3%) and one of infantile colic. Of the 85 individuals studied, 21 (24.7%) had a positive family history of pyloric stenosis, a higher frequency than previously reported.
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PMID:A medium term follow-up study of patients with hypertrophic pyloric stenosis. 819 45

One case of chronic intussusception (ileo-ileo colic) is reported. A seven and a half year old male had presented with colicky abdominal pain, vomiting, a palpable abdominal mass, infrequent passage of mucus or blood with stools and weight loss over a period of six weeks. There was delay in diagnosis due to unusual presentation and a low index of suspicion. The patient had been admitted to a peripheral general hospital for four weeks where he was treated for amoebic dysentery without improvement, before his transfer to our hospital where the diagnostic problem continued, until the paediatric surgical unit was called in.
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PMID:Chronic non-strangulating incompletely obstructing intussusception: with case report of a seven and a half year old Nigerian boy. 826 4

This is a case study of a 6-week-old infant referred for colic whose mother was using fluoxetine hydrochloride and breast feeding the infant. The mother switched to a commercial formula and reported a dramatic decrease in the infant's crying. We asked the mother to feed the infant breast milk from a bottle and she agreed. Throughout the study the mother kept a daily diary of her infant's crying, sleeping, stooling patterns, and feeding problems. Analysis of the mother's breast milk showed concentrations of 69 ng/mL for fluoxetine and 90 ng/mL for norfluoxetine. Infant blood serum/plasma level was analyzed for fluoxetine hydrochloride following return to breast milk. The concentrations were 340 ng/mL for fluoxetine and 208 ng/mL for norfluoxetine. The diary records showed increased crying, decreased sleep, increased vomiting, and watery stools when fluoxetine hydrochloride was transmitted through breast feeding or breast milk in bottle. These symptoms were reduced when the infant was formula fed. We suggest a possible relationship between colic and associated symptoms and fluoxetine hydrochloride in maternal breast milk.
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PMID:Possible association between fluoxetine hydrochloride and colic in an infant. 828 72

A total of 105 infants at "high risk" for developing allergy born in 1988 were studied prospectively from birth to 18 months of age. The infants were recommended breastfeeding and/or hypoallergenic formula (Nutramigen or Profylac) combined with avoidance of solid foods the first six months of life. All mothers had unrestricted diet. Avoidance of daily exposure to tobacco smoking, furred pets and dust collecting materials in the bedroom was advised. This prevention group was compared to a control group consisting of 54 identically defined "high-risk" infants born in 1985 in the same area. All the infants had either severe single atopic predisposition combined with cord blood IgE > or = 0.5 KU/l or biparental atopic predisposition. The control group had unrestricted diet and was not advised about environmental factors. The cumulative incidence of atopic symptoms was significantly lower at 18 months in the prevention group (32%) compared with the control group (74%) (p < 0.01), due to reduced incidence of recurrent wheezing (13% versus 37%; p < 0.01), atopic dermatitis (14% versus 31%; p < 0.01), vomiting/diarrhoea (5% versus 20%; p < 0.01) and infantile colic (9% versus 24%; p < 0.01). The cumulative incidence of food-allergy was significantly lower in the prevention group (6% versus 17%; p < 0.05). In both high-risk groups exposure to daily tobacco smoking increased the risk of recurrent wheezing significantly (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prevention of allergy in infants. A prospective study of 159 high-risk children]. 805 65

Cecal-colic volvulus was confirmed by surgery in two dogs. Both dogs were intact, male Great Danes. The clinical and diagnostic findings were not specific for large bowel volvulus. Clinical signs included peracute to acute onset of vomiting, mild abdominal distention and pain, lack of feces, and tenesmus. Abdominal radiographs demonstrated severe dilatation of bowel loops in both dogs. One dog survived.
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PMID:Cecal-colic volvulus in two dogs. 836 6

Although gout and hyperuricaemia are usually thought of as conditions of indulgent male middle age, in addition to the well-known uricosuria of the newborn, there is much of importance for the paediatric nephrologist in this field. Children and infants may present chronically with stones or acutely with renal failure from crystal nephropathy, as a result of inherited deficiencies of the purine salvage enzymes hypoxanthine-guanine phosphoribosyltransferase (HPRT) and adenine phosphoribosyltransferase (APRT) or of the catabolic enzyme xanthine dehydrogenase (XDH). Genetic purine overproduction in phosphoribosylpyrophosphate synthetase superactivity, or secondary to glycogen storage disease, can also present in infancy with renal complications. Children with APRT deficiency may be difficult to distinguish from those with HPRT deficiency because the insoluble product excreted, 2,8-dihydroxyadenine (2,8-DHA), is chemically very similar to uric acid. Moreover, because of the high uric acid clearance prior to puberty, hyperuricosuria rather than hyperuricaemia may provide the only clue to purine overproduction in childhood. Hyperuricaemic renal failure may be seen also in treated childhood leukaemia and lymphoma, and iatrogenic xanthine nephropathy is a potential complication of allopurinol therapy in these conditions. The latter is also an under-recognised complication of treatment in the Lesch-Nyhan syndrome or partial HPRT deficiency. The possibility of renal complications in these three situations is enhanced by infection, the use of uricosuric antibiotics and dehydration consequent upon fever, vomiting or diarrhoea. Disorders of urate transport in the renal tubule may also present in childhood. A kindred with X-linked hereditary nephrolithiasis, renal urate wasting and renal failure has been identified, but in general, the various rare types of net tubular wasting of urate into the urine are recessive and relatively benign, being found incidentally or presenting as colic from crystalluria. However, the opposite condition of a dominantly inherited increase in net urate reabsorption is far from benign, presenting as familial renal failure, with hyperuricaemia either preceding renal dysfunction or disproportionate to it. Paediatricians need to be aware of the lower plasma urate concentrations in children compared with adults when assessing plasma urate concentrations in childhood and infancy, so that early hyperuricosuria is not missed. This is of importance because most of the conditions mentioned above can be treated successfully using carefully controlled doses of allopurinol or means to render urate more soluble in the urine. Xanthine and 2,8-DHA are extremely insoluble at any pH. Whilst 2,8-DHA formation can also be controlled by allopurinol, alkali is contraindicated. A high fluid, low purine intake is the only possible therapy for XDH deficiency.
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PMID:Gout, uric acid and purine metabolism in paediatric nephrology. 843 71

A 6 months old girl with segmental dilatation of the jejunum is described. Clinical findings were intermittent colic, severe pain and bilious vomiting, mimicking intussusception. At laparatomy dilated jejunal segment was encountered and resection performed. Histological examination showed normal ganglion cells with normal bowel structures. Postoperative course was uneventful.
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PMID:Segmental dilatation of the jejunum. 899 65

Tumors composed of discrete round cells with large eosinophilic granules in their cytoplasm were observed in four cats. These cats were presented with severe gastrointestinal signs, including anorexia, vomiting, and diarrhea. The exploratory laparotomy in two cats and necropsy in the other two revealed thickening and perforation of the intestinal walls, enlargement of the mesenteric, ileocolic, and/or colic lymph nodes, and splenomegaly. Histologically, there was severe and disseminated infiltration of the tumor cells in the affected organs. In the two cats necropsied, the spleen and the jejunal mucosa appeared to be the primary organs involved. The tumor cells of all the cats showed the pore-forming protein (perforin)-like immunoreactivity unique to the cytotoxic lymphocytes but failed to show histamine immunoreactivity. These results indicate that the tumor cells were derived from large granular lymphocytes and that perforinlike immunoreactivity may be a useful marker for histologic diagnosis of feline large granular lymphoma.
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PMID:Perforin-like immunoreactivity in four cases of lymphoma of large granular lymphocytes in the cat. 906 84


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