ABSTRACT
Hypertrophic pyloric stenosis [HPS] is a common cause of gastric outlet obstruction [GOO] in infants. Prolonged GOO is believed to result in acid and electrolyte disturbances, gastric atony, and delayed postoperative recovery. We studied the impact of prolonged vomiting as an indicator of GOO symptoms on the post-operative outcomes in HPS. A retrospective chart review of all patients who underwent pyloromyotomy at a tertiary care center between February 1997 and February 2009. The duration of pre-operative vomiting was correlated with presenting electrolytes and acid-base balances, postoperative time to full feed, postoperative morbidity and duration of hospitalization. Forty-seven patients were identified. At presentation, the median [range] for duration of symptoms was 14 [3-60] days, and surgeries were performed at 2 [0-6] days after admission. Apart from one case of postoperative wound infection, all patients had an unremarkable recovery. The unusually prolonged duration of vomiting in our cohort did not correlate with the mean [SD] preoperative chloride level of 93.9 [8.8] mEq/L, mean [SD] pH level of 7.5 [0.9], mean postoperative time to full feeding of 31 [15.1] hours, or mean duration of hospitalization of 5.1 [2.2] days. Duration of vomiting in HPS at presentation does not seem to have a significant impact on the postoperative outcomes
Subject(s)
Humans , Male , Female , Vomiting/etiology , Vomiting/physiopathology , Postoperative Complications/blood , Gastric Outlet Obstruction/etiology , Gastric Outlet Obstruction/physiopathology , Gastric Outlet Obstruction/surgery , Digestive System Surgical Procedures/adverse effects , Acid-Base Imbalance , Recovery of Function , Time Factors , Treatment Outcome , Retrospective StudiesABSTRACT
OBJECTIVE: This study aimed to investigate the relationship between meal frequency, the occurrence of vomiting and weight loss among patients submitted to Roux-en-Y gastric bypass up to 9 months after surgery. METHODS: Female patients (n = 80) were followed at 3-month intervals for 9 months. Weight, BMI, 24-hour dietary recall, drug consumption and vomiting episodes were recorded and compared with nutritional outcome. RESULTS: The BMI values at 3, 6 and 9 months were 45.1 ± 9.7, 39.9 ± 7.6 and 35.4 ± 8.2 kg/m², respectively. The corresponding choleric intakes were 535.6 ± 295.7, 677.1 ± 314.7 and 828.6 ± 398.2 kcal/day, and the numbers of daily meals were 5.0 ± 2.5, 4.7 ± 1.8 and 4.9 ± 1.0, respectively. The peak of vomiting episodes occurred within 6 months; however, patients tolerated this complication despite its high prevalence. A significant negative correlation between weight loss and diet fractioning, but not vomiting, was observed throughout the entire postoperative period (P = 0.001). CONCLUSIONS: 1) Frequent small meals were associated with a reduction in weight loss after gastric bypass and a decrease in vomiting episodes at 6 months, and 2) vomiting did not interfere with nutritional outcome. Unless required because of vomiting or other reasons, multiple small meals may not be advantageous after such intervention.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Middle Aged , Young Adult , Feeding Behavior/physiology , Gastric Bypass , Weight Loss/physiology , Body Mass Index , Epidemiologic Methods , Postoperative Period , Vomiting/physiopathology , Young AdultSubject(s)
Humans , Anesthesia/adverse effects , Atropine/administration & dosage , Atropine/therapeutic use , Nausea/drug therapy , Nausea/physiopathology , Scopolamine/administration & dosage , Scopolamine/therapeutic use , Vomiting/drug therapy , Vomiting/physiopathology , Cholinergic Antagonists/administration & dosage , Cholinergic Antagonists/therapeutic use , Butyrophenones/therapeutic use , Cannabinoids/therapeutic use , Glycopyrrolate/administration & dosage , Glycopyrrolate/therapeutic use , Histamine H1 Antagonists/therapeutic use , Phenothiazines/therapeutic use , Receptors, Serotonin , Serotonin Antagonists/therapeutic useSubject(s)
Abdominal Pain/physiopathology , Acute Disease , Anastomosis, Surgical , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Enteritis/diagnosis , Female , Fever/physiopathology , Fluid Therapy , Humans , Intestinal Obstruction/physiopathology , Leukocytosis/physiopathology , Male , Suction , Survival Rate , Treatment Outcome , Vomiting/physiopathologyABSTRACT
Síntesis de la fisiología del acto del vómito y las causas que determinan su aparición tanto en el niño como en el lactante. Dar las pautas sobre el abordaje clínico y de estudio y por último una breve reseña de los medicamentos más comunmente utilizados para resolver este cuadro de una manera rápida y eficaz
Subject(s)
Humans , Infant , Child, Preschool , Child , Homeopathic Therapeutics , Vomiting/physiopathology , Aethusa cynapium/therapeutic use , Antimonium Crudum/therapeutic use , Arsenicum Album/therapeutic use , Calcarea Carbonica/therapeutic use , China officinalis/therapeutic use , Ipecac/therapeutic use , Kreosotum/therapeutic use , Podophyllum peltatum/therapeutic use , Veratrum album/therapeutic use , Vomiting/etiology , Vomiting/therapyABSTRACT
As novas técnicas de cirurgias videolaparoscópicas, por exemplo, permitem uma recuperaçao extremamente rápida dos pacientes, mas que encontram nos paraefeitos da anestesia (náuseas e vômitos) um dos fatores limitantes da completa recuperaçao dos pacientes em um tempo exíguo. Portanto é obrigaçao da equipe médica ter todos os conhecimentos sobre a fisiopatologia, bem como a terapêutica dos fenômenos eméticos, a fim de minimizar seus efeitos sobres os pacientes. O controle das náuseas e vômitos é, fundamentalmente, dever dos anestesiologistas, mas muitos dos fatores desencadeantes dos fenômenos eméticos nao estao, obrigatoriamente, ligados à anestesia mas, à própria cirurgia (estrabismo) ou à condiçao fisiológica do paciente no período perioperatório (período menstrual). Com esta revisao pretende-se mostrar os diversos fatores que influenciam na incidência da êmese pós-operatória, bem como a terapêutica a ser utilizada para seu tratamento.
Subject(s)
Humans , Anesthetics/adverse effects , Nausea/chemically induced , Postoperative Complications , Vomiting/chemically induced , Antiemetics/therapeutic use , Nausea/drug therapy , Postoperative Period , Risk Factors , Vomiting/drug therapy , Vomiting/physiopathologyABSTRACT
As naüseas e vômitos estäo entre as mais comuns angustiantes reaçöes associadas com a quimioterapia antineoplástica. Para o paciente säo efeitos colaterais que contribuem em até 10% como fator predisponente para o abandono do tratamento. O emprego de vários antieméticos, isolados ou combinados tem sido ensaiado com resultados conflitantes, mas a eficácia é demonstrada na maioria dos ensaios. O Autor, fundamentado na literatura especializada e na experiência prática de dez anos no Serviço de Oncologia do Hospital de Força do Galeäo, faz revisäo da fisiopatologia e terapêutica clínica da síndrome, valorizando a necessidade de se evitar o primeiro vômito
Subject(s)
Humans , Vomiting/chemically induced , Nausea/chemically induced , Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Vomiting/physiopathology , Vomiting/drug therapy , Combined Modality Therapy , Nausea/physiopathology , Nausea/drug therapy , Antiemetics/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic useSubject(s)
Humans , Vomiting/chemically induced , Nausea/chemically induced , Antiemetics/therapeutic use , Antineoplastic Agents/adverse effects , Phenothiazines/administration & dosage , Phenothiazines/pharmacology , Vomiting/physiopathology , Vomiting/drug therapy , Benzodiazepines/administration & dosage , Benzodiazepines/pharmacology , Butyrophenones/administration & dosage , Butyrophenones/pharmacology , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/pharmacology , Domperidone/administration & dosage , Domperidone/pharmacology , Metoclopramide/administration & dosage , Metoclopramide/pharmacology , Nausea/drug therapy , Antiemetics/administration & dosageABSTRACT
La presente revisión bibliográfica destaca que el vómito puede presentarse como única manifestación clínica del asma. Estos pacientes presentan tos o disnea, síntomas que pasan ind vertidos ante la severidad del vómito. Para diagnosticar esta variante de asma, es importante una historia clínica minuciosa y una buena exploración física. El contenido del vómito es moco muy abundante. Lo anterior permite distinguir el vómito asmático del que acompaña a enfermedades gastrointestinales. Queremos enfatizar que no se trata de la tos emetizante sino de vómito severo y recurrente que oscurece los otros síntomas clásicos del asma (tos, disnea y sibilancias) .
Subject(s)
Asthma/pathology , Vomiting/physiopathology , Mexico , Diagnosis, DifferentialABSTRACT
O artigo faz referência a dois distúrbios da eliminaçäo gastrintestinal - vômito e hematêmese; aborda suscintamente, conceito, fisiopatologia e causas mais comuns dos mesmos, estabelecendo ainda, a conduta de enfermagem na presença desses problemas