1/16. gastric outlet obstruction by a gallstone (Bouveret's syndrome).gastric outlet obstruction caused by a gallstone in the duodenum or pylorus(Bouveret's syndrome) is a very rare complication of gallstone disease. Presenting symptoms include epigastric pain, nausea, and vomiting. Preoperative diagnosis is not easy. Oral endoscopy is one of the diagnostic procedures. We present a case in which the diagnosis was made by endoscopic examination. Multiple attempts at endoscopic extraction of the gallstone from the duodenum were unsuccessful. A one-stage surgical procedure consisting of the removal of the impacted stone, fistula repair, and cholecystectomy was performed in this case. The postoperative course was uneventful.- - - - - - - - - - ranking = 1keywords = nausea (Clic here for more details about this article) |
2/16. Bouveret's syndrome presenting as upper gastrointestinal hemorrhage without hematemesis.A 74-year-old woman with a recent diagnosis of peptic ulcer disease diagnosed by endoscopy after presentation with an episode of upper gastrointestinal bleeding returned 6 1/2 weeks later with a 5-day history of nausea and vomiting without associated symptoms. An ultrasound was nondiagnostic except for a large gallstone and a poorly visualized gallbladder. Repeat endoscopy revealed a hard mass that was presumed to have formed secondarily to an ulcer-induced stricture, and a 6-cm filling defect just proximal to the duodenal bulb was seen on a preoperative upper gastrointestinal series. At laparotomy the mass was actually a large gallstone and two smaller stones, which had eroded into and become impacted in the duodenal bulb creating a gastric outlet obstruction. The stones were extracted via a duodenotomy, and the remaining portion of the gallbladder was removed with repair of the cholecystoduodenal fistula. The patient was discharged home after an uncomplicated postoperative course. gastric outlet obstruction by a duodenal gallstone is a condition known as Bouveret's syndrome, which is a rare complication of gallstone disease. Upper gastrointestinal hemorrhage is an especially rare form of presentation.- - - - - - - - - - ranking = 1keywords = nausea (Clic here for more details about this article) |
3/16. Abdominal cancer, nausea, and vomiting.nausea and vomiting in abdominal cancer is perhaps one of the most difficult symptom complexes to manage, especially when complicated by bowel obstruction. There are many mechanisms of nausea in advanced abdominal cancer with a number of therapeutic interventions that can significantly enhance symptom control and overall quality of life. As with pain, the ideal approach should include a mechanistic analysis of the causes of nausea beginning with a thorough history, followed by a directed physical examination, and selected laboratory studies. The symptom history, in conjunction with a physical examination and directed tests should direct appropriate pharmacologic and nonpharmacologic interventions. The result is often the amelioration of significant suffering and enhanced quality of living.- - - - - - - - - - ranking = 6keywords = nausea (Clic here for more details about this article) |
4/16. Antral hyperplastic polyp causing intermittent gastric outlet obstruction: case report.BACKGROUND: Hyperplastic polyps are the most common polypoid lesions of the stomach. Rarely, they cause gastric outlet obstruction by prolapsing through the pyloric channel, when they arise in the prepyloric antrum. CASE PRESENTATION: A 62-year-old woman presented with intermittent nausea and vomiting of 4 months duration. Upper gastrointestinal endoscopy revealed a 30 mm prepyloric sessile polyp causing intermittent gastric outlet obstruction. Following submucosal injection of diluted adrenaline solution, the polyp was removed with a snare. Multiple biopsies were taken from the greater curvature of the antrum and the corpus. Rapid urease test for helicobacter pylori yielded a negative result. Histopathologic examination showed a hyperplastic polyp without any evidence of malignancy. Biopsies of the antrum and the corpus revealed gastritis with neither atrophic changes nor helicobacter pylori infection. Follow-up endoscopy after a 12-week course of proton pomp inhibitor therapy showed a complete healing without any remnant tissue at the polypectomy site. The patient has been symptom-free during 8 months of follow-up. CONCLUSIONS: Symptomatic gastric polyps should be removed preferentially when they are detected at the initial diagnostic endoscopy. Polypectomy not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves radical treatment.- - - - - - - - - - ranking = 1keywords = nausea (Clic here for more details about this article) |
5/16. Giant duodenal gallstone presenting as gastric outlet obstruction: Bouveret's syndrome.In a 91 year old woman with nausea and vomiting, the diagnosis of Bouveret's syndrome was considered when a barium meal disclosed a cholecystoduodenal fistula and a giant filling defect in the duodenum. Because of her age and underlying medical illness, operative therapy was initially deferred. Repeated attempts to remove the intermittently obstructing duodenal gallstone endoscopically were unsuccessful using both endoscopic retrograde cholangiopancreatography retrieval baskets and an endoscopic mechanical lithotripter. The patient was referred for definitive operative therapy, and was discharged after a successful and uneventful enterolithotomy.- - - - - - - - - - ranking = 1keywords = nausea (Clic here for more details about this article) |
6/16. gastric outlet obstruction caused by a heterotopic pancreas in a pregnant woman: report of a case.A 26-year-old Japanese woman who was 23 weeks pregnant presented with nausea, vomiting, and abdominal pain. Gastroduodenal endoscopic examination revealed an oval-shaped submucosal tumor obstructing the gastric outlet at the prepyloric area in the stomach. magnetic resonance imaging showed a 5-cm cystic tumor and we suspected a degenerated gastrointestinal stromal tumor. No other radiological tests were done because of the associated risks to the fetus. Distal gastrectomy was performed and a histological diagnosis of heterotopic pancreas was confirmed. The patient had an uneventful postoperative course and was discharged 19 days after her operation. She delivered a healthy, full-term male infant 3 months later. This case of an ectopic pancreas obstructing the gastric outlet in a pregnant woman is reported and discussed due to its rarity.- - - - - - - - - - ranking = 1keywords = nausea (Clic here for more details about this article) |
7/16. gastric outlet obstruction caused by heterotopic pancreas.Heterotopic pancreas (HP) in the stomach is a relatively well-known entity, but there are not many symptomatic cases reported in children. We report on a 9-year-old boy presenting with nausea and vomiting. The first gastroscopic examination showed a crater-like lesion in the antrum, but at follow-up gastroscopy a few weeks later the lesion was polypoid, obstructing the pylorus. Endoscopic biopsy was not diagnostic, but histological examination after open excision showed HP. It is unclear why the lesion changed so markedly in appearance in just a few weeks. HP is a rare cause of gastric outlet obstruction in children.- - - - - - - - - - ranking = 1keywords = nausea (Clic here for more details about this article) |
8/16. Decompressive tube esophagostomy: a forgotten palliative procedure?Many patients with complete, irreversible upper gastrointestinal (GI) tract obstruction will require decompression for relief of intractable nausea and vomiting. Nasogastric (NG) tubes are associated with patient discomfort and risk. gastrostomy tubes may not be technically feasible in a small subset of patients with advanced upper GI tract malignancy. Decompressive tube esophagostomy is an underutilized, minimally invasive alternative in such patients. We present a case report, a description of the procedure, and a review of the literature for this palliative procedure.- - - - - - - - - - ranking = 1keywords = nausea (Clic here for more details about this article) |
9/16. Primary duodenal low-grade mucosa-associated lymphoid tissue lymphoma presenting with outlet obstruction.Low-grade lymphoma arising in mucosa-associated lymphoid tissue (MALT) of the duodenum represents a very rare neoplasm. We report an unusual presentation of primary duodenal MALT lymphoma in a 78-year-old man. The patient initially presented with a suspected pulmonary embolus and was anticoagulated, which precipitated a major gastrointestinal hemorrhage. A large atypical ulcer with narrowing of the duodenum beyond the bulb was seen on endoscopy. Biopsies revealed atypical lymphoid cells. Abdominal CT scan revealed a mass in either the duodenum or head of the pancreas. An endoscopic retrograde cholangiopancreatography (ERCP) was performed, which revealed a normal pancreatic duct with a large calculus in the common bile duct, which was extracted after sphincterotomy. Elective surgery was planned for suspected lymphoma of the duodenum. The patient developed severe nausea, vomiting, and fullness after meals. The patient underwent pancreaticoduodectomy for a neoplastic mass causing duodenal obstruction. Pathological examination of the resected specimen revealed a low-grade B-cell lymphoma (MALToma) arising in the duodenum and invading the pancreas. flow cytometry confirmed the phenotype typical of MALT lymphoma. Celiac, peripancreatic, pelvic, and cervical nodes were also involved with tumor. bone marrow was also positive for metastasis. The patient was postoperatively treated with chemotherapy for stage IV disease.- - - - - - - - - - ranking = 1keywords = nausea (Clic here for more details about this article) |
10/16. Gastrointestinal obstruction due to plaster ingestion: a case-report.BACKGROUND: Plaster ingestion forming gastric bezoar is a strange way to attempt suicide and this method has not yet been reported. It may lead to a mechanical obstruction of the gut, especially the pyloric region, and could manifest with abdominal pain, epigastric distress, nausea, vomiting, and fullness. CASE PRESENTATION: Herein we report a case of a 37 year-old woman presenting with plaster ingestion and gastric outlet obstruction, who underwent surgery. At six months follow-up the patient was fully recovered. CONCLUSION: Plaster has no toxic or erosive effects. Endoscopic or surgical removing of such material is recommended. Moreover, psychiatric intervention and management is imperative to prevent recurrence in such cases.- - - - - - - - - - ranking = 1keywords = nausea (Clic here for more details about this article) |
| | Next -> |