Chapter 039. Nausea, Vomiting, and Indigestion (Part 2) potx

Chapter 039. Nausea, Vomiting, and Indigestion (Part 2) Differential Diagnosis Nausea and vomiting are caused by conditions within and outside the gut as well as by drugs and circulating toxins (Table 39-1). Table 39-1 Causes of Nausea and Vomiting Intraperitoneal Extraperitoneal Medications/Metabolic Disorders Obstructing Cardiopulmonary Drugs disorders Pyloric obstruction Small bowel obstruction Colonic obstruction Superior mesenteric artery syndrome Enteric infections Viral Bacterial Inflammatory diseases Cholecystitis disease Cardiomyopathy Myocardial infarction Labyrinthine disease Motion sickness Labyrinthitis Malignancy Intracerebral disorders Malignancy Hemorrhage Abscess Hydrocephalus Cancer chemotherapy Antibiotics Cardiac antiarrhythmics Digoxin Oral hypoglycemics Oral contraceptives Endocrine/metabolic disease Pregnancy Uremia Ketoacidosis Thyroid and parathyroid disease Adrenal insufficiency Pancreatitis Appendicitis Hepatitis Altered sensorimotor function Gastroparesis Intestinal pseudoobstruction Functional dyspepsia Gastroesophageal reflux Chronic idiopathic nausea Functional vomiting Psychiatric illness Anorexia and bulimia nervosa Depression Postoperative vomiting Toxins Liver failure Ethanol Cyclic vomiting syndrome Biliary colic Abdominal irradiation Intraperitoneal Disorders Visceral obstruction and inflammation of hollow and solid viscera may produce vomiting as the main symptom. Gastric obstruction results from ulcer disease and malignancy, while small-bowel and colonic obstruction occur because of adhesions, benign or malignant tumors, volvulus, intussusception, or inflammatory diseases such as Crohn's disease. The superior mesenteric artery syndrome, occurring after weight loss or prolonged bed rest, results when the duodenum is compressed by the overlying superior mesenteric artery. Abdominal irradiation impairs intestinal contractile function and induces strictures. Biliary colic causes nausea via action on visceral afferent nerves. Vomiting with pancreatitis, cholecystitis, and appendicitis is due to localized visceral irritation and induction of ileus. Enteric infections with viruses or bacteria such as Staphylococcus aureus and Bacillus cereus are common causes of acute vomiting, especially in children. Opportunistic infections such as cytomegalovirus or herpes simplex virus induce emesis in immunocompromised individuals. . Chapter 039. Nausea, Vomiting, and Indigestion (Part 2) Differential Diagnosis Nausea and vomiting are caused by conditions within and outside the gut as well as by drugs and circulating. obstruction and inflammation of hollow and solid viscera may produce vomiting as the main symptom. Gastric obstruction results from ulcer disease and malignancy, while small-bowel and colonic. localized visceral irritation and induction of ileus. Enteric infections with viruses or bacteria such as Staphylococcus aureus and Bacillus cereus are common causes of acute vomiting, especially in