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

There is a high mortality rate in neonates with spontaneous rupture of the stomach. Clinical manifestations are vomiting, abdominal distension, respiratory distress and shock. An upright X-ray film showing a pneumoperitoneum is diagnostic. Successful treatment depends on early recognition of the condition and immediate surgical intervention. The case of a newborn with septicemia and spontaneous gastric rupture is described.
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PMID:[Spontaneous rupture of the stomach in a newborn infant with E. coli sepsis (author's transl)]. 703 76

A review of the world literature has revealed only 11 cases of gastric volvulus symptomatic in the first month of life. To those 11, this report adds two cases of intrathoracic organoaxial gastric volvulus that were observed in the first week of life and were managed operatively. Gastric volvulus should be considered in the differential diagnosis of newborn infants initially observed to have persisting regurgitation, vomiting, and respiratory distress. The diagnosis can be made with plain thoracoabdominal roentgenograms and confirmed by upper gastrointestinal contrast studies. Prompt surgical management is indicated and should include reduction and fixation of the stomach and repair of associated anomalies. The results of early surgery are excellent.
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PMID:Gastric volvulus in the newborn. 741 51

Although true vomiting is an unusual manifestation of pharyngeal or swallowing disorders in infants and children, the forceful regurgitation of feedings seen with respiratory distress in these children may be interpreted by the clinician as vomiting episodes. This scenerio usually is caused by structural abnormalities of the upper airway or swallowing discoordination placing food as an obstruction in the airway during feedings. A good clinical history and physical examination of affected children often will disclose an anatomic cause for regurgitated feedings, but swallowing disorders are more subtle and usually require a complete swallowing evaluation. The essential components in treating these problems in children include the removal of the airway obstruction or rehabilitation of feeding and swallowing. The approach to treatment is often multidisciplinary in nature and highly individualized.
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PMID:Pharyngeal and swallowing disorders in infants. 758 86

A progressive pulmonary disease resulting in severe respiratory failure and death in an average of 3 weeks was diagnosed in 11 young Dalmatian dogs. The dogs were from 4 litters, all genetically related by a common ancestor. The initial clinical signs were tachypnea and noisy respiration. Respiratory distress developed shortly before death and was characterized by strenuous and rapid respirations, along with cyanosis and vomiting. On blood gas analysis, there were severe arterial hypoxemia, hypercapnia, and marked alveolar-arterial oxygen difference. Radiographically, a diffuse pattern of alveolar, interstitial, and peribronchial densities was observed in the lungs. Most dogs developed pneumomediastinum and gastroesophageal intussusception in the terminal phase of the disease. There was no response to treatment with antibiotics, corticosteroids, diuretics, or oxygen. At necropsy, the lungs were wet, heavy, and relatively airless. Absence of 1 kidney in 2 dogs and severe internal hydrocephalus in 2 dogs were additional necropsy findings. Pulmonary histopathology included metaplasia and atypia of the alveolar and bronchiolar epithelium, a nonpurulent inflammatory reaction characterized mainly by mononuclear cells and macrophages, eosinophilic hyaline membrane formation, and focal pulmonary fibrosis. The histological manifestations were typical of acute lung injury. Clinically, the findings were consistent with adult respiratory distress syndrome (ARDS), except for the relatively long course. No known risk factors for ARDS, such as trauma, toxin exposure, infection, or endotoxemia could be identified. The relationship of the other abnormalities (ie, renal aplasia, hydrocephalus) to the pulmonary disease also remains obscure. An inherited defect is suspected, because segregation analysis of the 4 litters suggests autosomal recessive inheritance.
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PMID:Lung injury leading to respiratory distress syndrome in young Dalmatian dogs. 767 17

The addition of thyrotropin-releasing hormone (TRH) to antenatal glucocorticoid treatment of women at risk of preterm delivery has been reported to lower the risk of respiratory distress syndrome (RDS) in the infant. We have assessed the efficacy of 200 micrograms TRH in a multicentre randomised trial. 1234 women at 24 weeks to 31 weeks 6 days of gestation with a singleton or twin pregnancy and at risk of preterm delivery were randomly allocated to groups receiving 200 micrograms TRH or placebo intravenously every 12 h up to a maximum of four doses. Randomisation was stratified by duration of gestation and centre. All women received glucocorticoids. Clinical outcome is known for 1231 women and their 1397 infants. The frequencies of the main prespecified study outcomes RDS (relative risk 1.17 [95% CI 1.00-1.36], p = 0.05) and need for ventilation (1.15 [1.01-1.31], p = 0.04) were higher in TRH-group infants than in control infants. The excess risk in the TRH group was greater in infants who were born more than 10 days after treatment. Multivariate analysis adjusting for duration of gestation at randomisation, time from randomisation to delivery, parity, history of perinatal death, and infant's sex did not affect the risk estimates. TRH administration was associated with increased risks of maternal nausea, vomiting, lightheadedness, and a rise in blood pressure to 140/90 mm Hg or higher. Antenatal TRH given with glucocorticoids to women at high risk of preterm delivery is associated with maternal and perinatal risks and cannot be recommended for widespread clinical use.
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PMID:Australian collaborative trial of antenatal thyrotropin-releasing hormone (ACTOBAT) for prevention of neonatal respiratory disease. 779 58

BACKGROUND. Exposure of pregnant women to angiotensin converting enzyme inhibitor may have side effects on the fetus or newborn, mainly oligoamnios and impaired renal function. CASE REPORT N zero 1. A 34 year-old woman was given enalapril from the onset of her pregnancy because of hypertension from the age of 18 years. Oligoamnios was diagnosed in the fetus on gestational week 28; enalapril was then replaced by nifedipine but this drug was badly tolerated so that the woman was again given enalapril 8 days later. The baby (1700 g) was born by cesarean section at gestational week 34 because of acute distress syndrome; he developed hypotension, anuria, generalized oedema and was placed in intensive care. Treatment included ventilation, sympathomimetic agents, and diuretics. An exchange-transfusion followed by peritoneal dialysis was performed a few hours later. Renal function returned to normal between the 3rd and 5th day. Unilateral kidney hypoplasia was diagnosed at the age of 2 years. CASE N zero 2. A 24 year-old woman was given enalapril at the third trimester of a twin pregnancy. Delivery was full term at 37 weeks. The first baby, a boy weighing 2610 g, suffered from hypoglycemia and vomiting followed by hypotension and oliguria that required exchange-transfusion and repeated peritoneal dialysis. This boy has developed moderate chronic renal failure and hypertension. The second baby, a girl weighing 2,165 g, suffered from respiratory distress syndrome followed by hypotension and oliguria, but her renal function returned to normal within a few days. CONCLUSIONS. The use of angiotension converting enzyme inhibitor by pregnant women places the fetus at severe risk: treatment with this type of drug should be stopped as soon as pregnancy is confirmed.
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PMID:[Fetal and neonatal effects of maternal treatment with angiotensin converting enzyme inhibitor]. 795 36

Acute gastric volvulus occurred in nine infants and one older child during the past 19 years; all patients had an associated left diaphragmatic anomaly. There were seven examples of eventration of the diaphragm, two of giant hiatal hernia and one Bochdalek hernia. Nine of the ten patients presented with vomiting and one with acute respiratory distress. The gastric volvulus was mesenteroaxial in eight patients and organoaxial in two. Operative treatment consisted of repair of the diaphragmatic anomaly and gastric fixation in eight patients. Gastric fixation alone was performed in one patient. A single patient died preoperatively and had gastric necrosis at postmortem examination. Of the nine patients treated operatively, all remain alive and well without recurrence. Acute gastric volvulus should be considered in any infant presenting with unexplained vomiting in association with a left diaphragm anomaly, and once diagnosed, immediate operation is mandatory.
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PMID:The pediatric diaphragm in acute gastric volvulus. 814 14

The effects of position (upright vs reclining) and support (held vs chair) on the development and maintenance of feeding behavior were examined in a child with bronchopulmonary dysplasia and gastroesophageal reflux. A reclining position initially facilitated acceptance and swallowing with relatively rapid generalization to an upright position. Oral-motor skills did not differ across levels of support. Practice of emerging motor skills preceded increases in vomiting, as well as episodes of respiratory distress. This study illustrates a methodology that can be employed to elucidate complex interrelationships among oral-motor skills, gross motor skills and functioning, and symptoms of gastroesophageal reflux.
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PMID:Effect of position and support on oral-motor skills of a child with bronchopulmonary dysplasia. 815 30

Neonatal brain tumor is rare, but is so important a disease when considering the pathogenesis of the brain tumor that numerous review articles have been described. Today, the availability of noninvasive imaging procedures such as CT and MRI make it easy to diagnose, and some successful operative cases have been reported. We report three cases of neonatal brain tumors presented clinically within the first 2 weeks. Case 1: A full term boy admitted with projectile vomiting, enlarged head and left peripheral type facial palsy at the age of 12 days. CT scan revealed a large heterogeneous mixed-density mass in the left cerebellar hemisphere. Partially removed surgical specimen consisted of primitive glial cells differentiating with the ependymal cell immunohistochemically and electron microscopically, and diagnosed as ependymoblastoma. He had whole brain irradiation postoperatively, but died from respiratory distress 7 months later without tumor regrowth indicated on CT. Case 2: A full term boy admitted with progressive enlarging of the head at the age of 10 days. CT scan revealed a high-density mass in the cerebellar vermis and an obstructive hydrocephalus. Partially removed surgical specimen, diagnosed as medulloblastoma. He was irradiated throughout the whole brain and spinal cord, but died from intracranial dissemination 5 months later. Case 3: A 32-year-old female multipara was diagnosed as hydramnion during 28 weeks gestation. The concentration of AFP was very high in the amniotic fluid. A premature female fetus, weighing 1,650 g, was delivered by cesarean section for premature separation of the placenta during an estimated 30 weeks gestation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Neonatal brain tumor, a report of three cases]. 816 55

There is a significant incidence of inguinal hernia in premature infants and the optimal timing of repair is controversial. A high rate of postoperative respiratory complications has been reported in this group. In this study, the records of 47 premature infants (mean gestational age, 30.3 weeks) who underwent herniorrhaphy while still in the neonatal intensive care unit were reviewed in an effort to define those conditions that are independent risk factors for complications. Forty-three percent of infants had complications, including postoperative assisted ventilation (34%), episodes of apnea and/or bradycardia (23%), emesis and cyanosis with first feeding (6%), and requirement for postoperative reintubation (4%). Although low gestational age and postconceptual age at operation, low birth weight for gestational age, and preoperative ventilatory assistance were significantly associated with postoperative complications, only a history of respiratory distress syndrome/bronchopulmonary dysplasia (odds ratio 2.3), a history of patent ductus arteriosus (odds ratio 2.5), and low absolute weight at operation (odds ratio 3.5 for 1,000-g decrease) were independent risk factors for postoperative complication. Despite previous reports citing postconceptual age as the factor having the greatest impact on postoperative complications, these results indicate that a history of respiratory dysfunction and size at operation may be more important predictors of postoperative respiratory dysfunction in preterm infants.
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PMID:Predictors of postoperative respiratory complications in premature infants after inguinal herniorrhaphy. 843 90


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