Cases reported "Vomiting"

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1/208. An unusual clinical presentation of pancreatic carcinoma: duodenal obstruction in the absence of jaundice.

    A case of pancreatic carcinoma, presenting with the uncommon initial manifestation of vomiting secondary to duodenal obstruction without jaundice, is reported. A review of 72 consecutive biopsy-proven cases of pancreatic carcinoma admitted to our institution in the past five years revealed an 8.3% incidence of this unusual primary complaint. Although infrequently reported previously, pancreatic carcinoma should be considered in the differential diagnosis of gastric outlet obstruction in the absence of jaundice. The classic triad of progressive jaundice, weight loss and abdominal pain suggests carcinoma of the head of the pancreas. Emesis, secondary to high grade duodenal obstruction in the absence of jaundice, is an infrequent clinical presentation. The case described is illustrative of widespread pancreatic carcinoma that remained silent until obstruction developed.
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ranking = 1
keywords = abdominal pain
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2/208. Diaphragmatic hernia of Morgagni.

    Most cases of Morgagni hernia are asymptomatic and diagnosed incidentally on routine chest x-ray film, but they may occasionally become symptomatic. Symptomatic Morgagni hernias may present in many different ways, making the diagnosis challenging. We describe a patient with a Morgagni hernia, resulting in intractable nausea and vomiting, give a brief review of symptoms, note the different types of abdominal contents herniated, and describe the methods used to make the diagnosis.
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ranking = 0.0085519585676108
keywords = chest
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3/208. Congenital splenic cyst--a report of two cases.

    We report on two girls with large epidermoid splenic cysts. They presented with abdominal pain, fever, and non-bilious vomiting. In both cases the cyst was diagnosed by means of computer tomography and ultrasonography. One of the patients was successfully treated with partial splenectomy. In the other case percutaneous drainage was initially carried out, but this treatment was insufficient. splenectomy was then performed.
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ranking = 1
keywords = abdominal pain
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4/208. Diagnosis of Chilaiditi's syndrome with abdominal ultrasound.

    Chilaiditi's sign is a radiographic term used when the hepatic flexure of the colon is seen interposed between the liver and right hemidiaphragm. When symptomatic, this is Chilaiditi's syndrome. We report a case of a 70-year-old man who presented with abdominal pain, vomiting, singultus and constipation. Ultrasound was initially performed which showed an intestinal loop between the anterior surface of the right liver lobe and the diaphragm. The chest X-ray revealed colon gas under the right diaphragma and the abdominal CT-scan confirmed the hepatodiaphragmatic interposition of the colon. Colonic elongation and laxity of colonic and hepatic suspensory ligaments are the principal predisposing factors. The advantages of the abdominal ultrasound in the diagnosis and follow-up as well as possible complications and forms of therapy with this syndrome are discussed.
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ranking = 1.0085519585676
keywords = abdominal pain, chest
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5/208. Use of mechanical thrombolysis via microballoon percutaneous transluminal angioplasty for the treatment of acute dural sinus thrombosis: case presentation and technical report.

    OBJECTIVE AND IMPORTANCE: Although conventional superselective chemical thrombolysis is frequently successful for the treatment of severe acute dural sinus thrombosis, the technique has limitations and risks. This prompted us to develop a supplemental technique for achieving more rapid recanalization, using coronary microballoon percutaneous transluminal angioplasty catheters. We describe a successful application of this technique and technology that has not been previously reported. CLINICAL PRESENTATION: After several days of severe headaches, photophobia, and vomiting, a 29-year-old woman presented with rapidly progressive neurological deficits secondary to complete occlusion of the superior sagittal sinus (SSS) and right transverse/sigmoid sinus complex. Owing to her rapid neurological decline, she was referred for emergency endovascular intervention. TECHNIQUE: Initially, superselective chemical thrombolysis of the SSS was performed using urokinase. However, because of the extensive nature of the thrombus and lack of initial therapeutic response, we elected to attempt mechanical thrombolysis with various coronary percutaneous transluminal angioplasty microballoon catheters. This was accomplished by initial coaxial positioning of the device into an occluded segment, followed by gentle inflation and retraction of the device along the course of the right transverse sinus and/or SSS. These maneuvers were repeated with balloons of increasingly large diameter. Near-complete restoration of venous outflow was obtained within the SSS with preferential runoff into the left transverse sinus. The right transverse sinus was only partially recanalized. Despite the patient's rapid neurological decline on presentation, she experienced a dramatic clinical recovery with near-complete reversal of neurological deficits within 24 hours of intervention. CONCLUSION: This report shows the feasibility of performing safe and effective mechanical thrombolysis with percutaneous transluminal angioplasty coronary balloon microcatheters within the major dural sinuses. This technique can probably accelerate clot disruption and thrombolysis, possibly resulting in a more rapid restoration of venous flow.
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ranking = 0.19238177458664
keywords = headache
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6/208. Paraesophageal hernia in an elderly woman with vomiting.

    We describe the case of a 79-year-old woman who presented with resolved episodes of vomiting and was found to have a paraesophageal hernia. Her initial evaluation was unremarkable, and the diagnosis was established only by the use of screening chest radiography. Once the diagnosis was confirmed, the patient required urgent surgical repair. Paraesophageal hernia is a rare clinical entity with the potential for life-threatening complications, making the diagnosis itself an indication for surgery. This case illustrates the fact that significant pathology may be present with few, if any, physical findings in the elderly patient, and thorough evaluations are required for the diagnosis of such occult pathology.
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ranking = 0.0085519585676108
keywords = chest
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7/208. Familial fatal and near-fatal third ventricle colloid cysts.

    BACKGROUND: Despite having a presumed congenital origin, familial cases of colloid cysts have been reported only rarely. The first case of a brother and sister with colloid cysts is reported here, and the relevant literature is reviewed. methods: A 25-year-old man presented with a 24-h history of headache and vomiting. He rapidly became unconscious and fulfilled the criteria for brain death on arrival at hospital. No surgical intervention was performed. RESULTS: The patient's sister presented at the age of 41 with headaches and rapidly became unconscious. The sister had urgent bilateral ventriculostomies. followed by transcallosal removal of a colloid cyst. CONCLUSIONS: These cases support the hypothesis that colloid cysts are congenital lesions and provide some evidence of a possible genetic predisposition to their formation. Sudden death remains a real risk for patients harbouring a colloid cyst.
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ranking = 0.38476354917327
keywords = headache
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8/208. 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.
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ranking = 0.15711808085568
keywords = discomfort
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9/208. addison disease after appendicitis.

    A 14-year-old boy manifested acute abdominal pain, vomiting, high temperature and diarrhea. He also underwent increasing hyponatremia and hyperkalemia after appendectomy. Further testing confirmed addison disease. The serum adrenal antibody test was positive, and other autoimmune diseases were excluded.
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ranking = 1
keywords = abdominal pain
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10/208. Right-sided pleural effusion in spontaneous esophageal perforation.

    Spontaneous esophageal perforation (Boerhaave's syndrome) is a rare clinical entity in which overindulgence in a large meal precedes vomiting and chest pain. early diagnosis and aggressive management are keys to minimizing the morbidity and mortality. We report an unusual presentation of this already uncommon occurrence in a 33-year-old female. She presented to the Emergency Department with severe chest pain following vomiting with hematemesis after a large meal. The initial chest radiograph showed up nothing in particular. dyspnea developed two days later, and a right-sided pleural effusion was seen on chest x-ray. Panendoscopy was highly suggestive of Boerhaave's syndrome. She underwent emergency operation. After three months of hospital care, she was discharged in relatively good condition. This case of right-sided pleural effusion extends the reported description of Boerhaave's syndrome.
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ranking = 0.034207834270443
keywords = chest
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