Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case report of mesenteric venous thrombosis with small bowel infarction in a 38-year-old woman who had been taking oral contraceptives is reported. The patient was admitted complaining of severe abdominal pain and vomiting for 36 hours. On admission, temperature was 37.5 degrees C and pulse 120/minute. Abdominal rigidity and left-sided abdominal tenderness were present. X-ray of the abdomen showed 2 distended loops of small bowel and 3 fluid levels. Serum amylase was normal. White cell count was 10,000/cu mm. There was a history of abdominal pain and diarrhea over a period of several years. For 6 months she had been taking Ovulen (mestranol .1 mg and ethynodiol diacetate .5 mg) for menstrual irregularity. 2 weeks earlier she had suffered an influenzalike illness with pleuristic chest pain, loin pain, urinary frequency, and dysuria. Chest X-ray and intravenous pylography were then reported as normal. At immediate operation, a 15 cm segment of ileum was found to be infarcted. Semipurulent fluid was present in the abdomen and areas of fibrinous peritonitis were observed. The involved segment of ileum was resected. A small thrombus was extracted from a mesenteric vein. Initial postoperative course was good but 3 days after operation chest pain, dyspnea, and giddiness developed and cardiac arrest followed. Resuscitation was successful. Pulmonary angiography then showed thrombi in all branches of the pulmonary artery. After heparin therapy symptoms improved and the patient left the hospital in 2 weeks, her condition being stabilized with warfarin and dipyridamole (Persantin). The diagnosis was confirmed by histological examination. Early recanalization of a mesenteric vein was noted. Other reported cases have shown an average prodromal phase of 4 or 5 days. The long-term diarrhea was considered as not connected with the present illness but the presumed influenza illness 2 weeks earlier may have been due to a pulmonary embolism. Of reported cases, 5 of 13 have died. Early diagnosis, prompt surgery, and heparin therpay are considered important.
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PMID:Mesenteric venous thrombosis associated with oral contraceptives: a case report. 106 70

A report from a medium-sized community hospital of 4 additional cases of hepatocellular adenoma is presented. Of these, 3 were pedunculated tumors. A 29-year-old woman, gravida 7, had been taking Enovid-E for 8 years. After 3 attacks of epigastric pain a mass was detected in her right upper abdomen. Surgical exploration revealed the mass pedunculated from the right hepatic lobe. The mass was excised. 3 years later a liver scan was normal. The histological appearance of the tissue resembled mature hepatic architecture without protal areas or bile ducts. A 34-year-old woman, gravida 4, para 2, had been taking Enovid-E for 6 years. She previously had had a partial thyroidectomy for carcinoma of the thyroid and later radical neck dissection for metastatic thyroid carcinoma. A mass was detected in the right abdomen. At operation, a pedunculated mass was found attached to the right hepatic lobe with 2 smaller nodules. All lesions were excised. The microscopic picture was similar to that of the other patient. A 24-year-old woman, gravida 4, para 3, had been taking Oracon for 1 year. Upper abdominal pain, vomiting, and diarrhea were complained of. An upper abdominal mass was present. At operation, a 9 cm mass was excised. The histology was the same as in the previous cases. A 28-year-old woman, gravida 2, para 1, had been taking Ovulen for 5 years. An abdominal mass was present. Surgical exploration revealed a nodular mass pedunculated from the left lobe of the liver. The mass was excised. Histological appearance was similar to the other 3 tumors. Of 42 other reported cases of similar tumors, the mean age was 27.3 years. About 40% had been admitted as emergency cases with hemoperitoneum. Almost 20% had complained of upper abdominal pain. A palpable mass was usually present. Multiple nodules were found in 13% of cases. For nonemergency cases, selective hepatic angiography has been a reliable method of diagnosis. The treatment has been resection of the tumor when feasible. However, regression of tumors has occurred when exogenous hormone influence ceased. The outcome has been fatal in 8 cases. The low incidence of this tumor is not considered sufficient cause to justify discontinuing use of oral contraceptives.
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PMID:Hepatocellular adenoma and oral contraceptives. 127 46