functional vomiting
Introduction
Introduction to functional vomiting Functional vomiting is the involuntary contraction of abdominal muscles, and the contents of the stomach caused by the relaxation of the fundus and lower esophageal sphincters are forced out. Because of the complex and diverse causes of functional vomiting, the occurrence and duration of functional vomiting, and varying degrees of age and age, the impact on the body is very different. The lighter has no effect, only a temporary discomfort. basic knowledge The proportion of illness: 0.02% Susceptible people: no specific population Mode of infection: non-infectious Complications: acute gastroenteritis pyloric obstruction gastric torsion acute appendicitis cholelithiasis acute pancreatitis ureteral calculi acute pelvic inflammatory disease myocardial infarction glaucoma
Cause
Cause of functional vomiting
Because of the complex and diverse causes of functional vomiting, the occurrence and duration of functional vomiting, and varying degrees of age and age, the impact on the body is very different. The lighter has no effect, only a temporary discomfort. Long-term chronic functional vomiting. It can cause metabolic disorders such as digestive esophagitis, hypovolemia, hypokalemia, low sodium, and alkalosis. Further, anemia, malnutrition, and growth and development are stagnant.
When it is heavy, it can cause water and electrolyte balance disorder, shock or aspiration, suffocation, induced heart rhythm or even death. Caused by surgical reasons can also lead to serious consequences such as perforation of the digestive tract, diffuse peritonitis, shock, sepsis. Those with motor dysfunction are also prone to aspiration after functional vomiting and need to be vigilant.
Prevention
Functional vomiting prevention
Functional vomiting is the forced discharge of gastric contents caused by the involuntary contraction of the abdominal muscles and the relaxation of the lower esophageal sphincters. The prevention of functional vomiting should be smooth and consistent with the direction of peristalsis of the large intestine, and at the proximal end of the anastomosis, 2 to 3 needles should be strengthened, and the muscle layer of the sarcoplasmic layer should be sutured to make the direction of peristalsis more consistent. If the ileum is double-ended, the distal end of the ileum is anastomosed to the proximal end of the colon. The proximal ileum is anastomosed to the distal end of the colon. The two anastomosis should be about 5 cm apart to prevent reflux.
If the lesion fails to cause complete obstruction of the intestine, the end of the ileum is closed, and the proximal ileum is anastomosed at the proximal end of the colon lesion. This is a big mistake. Because the lesion develops into complete obstruction, the secretion of intestinal mucosa between the closed mouth and the lesion increases, gradually expands, and can form a peritonitis, which is a surgical error.
Complication
Functional vomiting complications Complications Acute gastroenteritis pyloric obstruction gastric torsion acute appendicitis cholelithiasis acute pancreatitis ureteral calculi acute pelvic inflammatory disease myocardial infarction glaucoma
Digestive system:
Pharyngeal stimulation (such as artificial stimulation), acute gastroenteritis, chronic gastritis, active peptic ulcer, acute gastrointestinal perforation, pyloric obstruction, massive bleeding, gastric mucosal prolapse, acute gastric dilatation, gastric torsion, acute enteritis, Acute appendicitis, mechanical intestinal obstruction, acute hemorrhagic necrosis enteritis, acute hepatitis, chronic active hepatitis, advanced cirrhosis, acute chronic cholecystitis, cholelithiasis, biliary ascariasis, acute pancreatitis, acute peritonitis.
Other systems:
Genitourinary diseases: ureteral stones, acute renal nephritis, acute pelvic inflammatory disease, rupture of ectopic pregnancy, etc.
Cardiovascular diseases:
Myocardial infarction, congestive heart failure, etc.; eye and ear diseases and others: glaucoma, refractive error, etc.
Symptom
Functional vomiting symptoms common symptoms early pregnancy response to heavy eating abnormal nervous nausea
For neurological vomiting, although symptoms have been weeks or months, patients usually have no weight loss, dehydration or objective clinical abnormalities, but for patients with severe psychological disorders, including eating abnormalities, due to persistent vomiting, malnutrition and Metabolic disorders, vomiting does not occur after the expected physiological activities, such as vomiting when the patient thinks of food, may be related to eating, vomiting is self-induced in patients with abnormal eating.
In order to clarify the psychiatric causes of vomiting, it is necessary to clarify the behavioral characteristics of vomiting, which may not be allowed in time. The patient may have a personal history and family history of functional nausea and vomiting, which may serve as a model of existing symptoms. Encouraging patients to describe the background of vomiting episodes, while linking vomiting to stress, and claiming that vomiting relapses and worsens during similar stress periods, patients still do not recognize vomiting as related to mental stress.
Examine
Functional vomiting
First, X-ray examination: abdominal plain film, visible dilated bowel (obstructive lesion proximal tubule). Intestinal angiography: It shows that the expectorant is retrograde from the anastomosis into the intestine of the intestine, and a part of it is retrograde into the proximal intestine of the fistula through the stenosis, and then pushes the expectorant into the distal end of the anastomosis by peristalsis, or reverse creeps to Anastomotic site.
Second, B-mode ultrasound: can explore the original colon lesions and their proximal expansion of the intestine.
Diagnosis
Functional vomiting diagnosis
Medical history, physical examination and original laboratory data can often reasonably exclude obvious gastrointestinal diseases (such as cholecystitis, common hepatic duct stones, intestinal obstruction, peptic ulcer, acute gastroenteritis, visceral perforation or other acute abdomen, intake Hazardous substances), abnormalities of other organ systems (such as acute pyelonephritis, myocardial infarction, acute hepatitis), poisoning or metabolic diseases (such as systemic infections, radiation exposure, drug poisoning, diabetic ketoacidosis, cancer), neurological Causes (such as stimulation of the vestibular center, pain, meningitis, central nervous system trauma, tumors).
If medical history and physical examination cannot rule out physical illness, further research should be conducted based on the clinical data obtained, including complete blood count, blood glucose, erythrocyte sedimentation rate, urea nitrogen, electrolytes, urine analysis, liver function tests, fecal occult blood test, including A series of upper digestive tract examinations and abdominal ultrasound examinations of the small intestine, if these results are normal (ie, excluding upper digestive tract, metabolic and toxic diseases), can be reasonably diagnosed as mental nausea and vomiting.
