1/4. Gastric adenocarcinoma presenting with persistent, mild gastrointestinal symptoms in pregnancy. A case report.BACKGROUND: Mild gastrointestinal symptoms are common during pregnancy but can also be the only symptoms in stomach cancer until the late stage. Clinicians' reluctance to pursue diagnostic studies appears to be a major contributing factor to delayed diagnosis and poor outcome. We report a case of maternal death to alert clinicians to this rare possibility. CASE: A 36-year-old woman had persistent, mild epigastric discomfort, nausea, vomiting and frequent episodes of dark stools since the second trimester of pregnancy. These were attributed to peptic ulcer and an iron supplement given, without investigation. gastroscopy was performed only at 32 weeks of gestation, when the patient had heavy hematemesis. biopsy confirmed the diagnosis of poorly differentiated adenocarcinoma of the stomach. cesarean section was performed after steroid therapy. Advanced stomach cancer with stomach perforation was found. Curative surgery was not possible. The patient died four weeks after delivery. CONCLUSION: stomach cancer is a rare complication of pregnancy. Delay in diagnosis is commonly due to clinicians' reluctance to request diagnostic studies and the nonspecific symptoms of the disease. Early recognition and diagnosis are the only possibilities for a better outcome. Clinicians must be alert to this possibility and include this in the differential diagnosis of minor gastrointestinal discomfort during pregnancy.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
2/4. Acute pancreatitis occurring in the early postpartum period: a case report.We report a case of acute pancreatitis, which occurred after delivery in a woman who had an uneventful course of pregnancy and parturition. A 17-year-old Japanese woman was referred to our department because of nausea and vomiting two hours after delivery, followed by severe abdominal and back pain. On admission, in addition to elevated serum and urine amylase, plain computed tomography demonstrated a swollen pancreas and high density in the peripancreatic lesion with a large amount of ascites, suggesting the presence of an inflammation of the pancreas as well as peripancreatic lesion. Accompanied by subsiding abdominal and back pain, serum amylase concentration gradually decreased and returned to a normal level on the 11th postpartum day. Acute pancreatitis must be kept in mind when evaluating patients presenting with abdominal pain after delivery.- - - - - - - - - - ranking = 3keywords = delivery (Clic here for more details about this article) |
3/4. enteral nutrition in hyperemesis gravidarum: a new development.hyperemesis gravidarum occurs in up to 2% of pregnancies. hospitalization is commonly required to treat dehydration and electrolyte and metabolic imbalances. Severe forms of hyperemesis gravidarum involving weight loss greater than 5% of prepregnancy weight have been associated with poor fetal growth and outcome. hyperemesis gravidarum is a high-risk condition from a nutritional perspective. Traditional approaches to nutrition management focus on the cautious introduction of fluids and low-fat solids following resolution of acute nausea and vomiting. When trials of oral feeding fail to be tolerated, consideration should be given to the enteral route as the means of nutritional rehabilitation. A carefully designed delivery regimen combined with antiemetic therapy can prevent abdominal or sensory episodes that might precipitate further vomiting. Two case studies of the successful use of enteral nutrition in hyperemesis gravidarum are presented. Although clinical experience is limited and further research is needed, early results suggest that enteral nutrition in hyperemesis gravidarum is an effective and safe technique.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
4/4. Treatment of migraine headache after ocular surgery with intravenous metoclopramide hydrochloride.PURPOSE: To alert ophthalmologists that prolonged or severe postoperative periocular pain and nausea may be caused by migraine. methods: We examined two patients who had a history of migraine and had severe episodes of prolonged periocular pain and nausea after ocular procedures. Both patients experienced symptoms similar to their previous migraine attacks. In neither was pain alleviated by routine analgesics. RESULTS: Each patient had relief of symptoms within two minutes after intravenous delivery of metoclopramide hydrochloride. CONCLUSIONS: Ophthalmologists should consider the diagnosis of postoperative migraine in similar patients and provide specific therapy such as intravenous metoclopramide hydrochloride.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |