Nausea and Vomiting



Nausea and Vomiting





Nausea and vomiting result from a wide variety of diverse causes. Nausea appears to be produced by stimulation of the central nervous system chemoreceptor trigger zone, which may be activated by a wide variety of drugs and endogenous stimuli. Vomiting is induced by stimulation of the vomiting center in the medulla, which receives input from the gastrointestinal tract, the cerebral cortex, the vestibular apparatus, and the chemoreceptor trigger zone. Complications of vomiting include dehydration, fluid and electrolyte disturbances (including metabolic alkalosis, hypokalemia, and hyponatremia), aspiration of vomitus, gastroesophageal mucosal laceration (Mallory-Weiss syndrome), and postemesis rupture of the esophagus (Boerhaave syndrome).


CAUSES OF NAUSEA AND VOMITING COMMONLY ASSOCIATED WITH ABDOMINAL PAIN



  • Gastroenteritis


  • Anxiety


  • Mechanical obstruction of the gastrointestinal tract


  • Biliary tract disease


  • Food poisoning


  • Alcoholic gastritis


  • Renal colic


  • Pancreatitis


  • Peptic ulcer disease


  • Drugs (narcotics, nonsteroidal anti-inflammatory agents, antibiotics)


CAUSES OF NAUSEA AND VOMITING NOT ASSOCIATED WITH ABDOMINAL PAIN



  • Pregnancy


  • Labyrinthine disorders


  • Uremia


  • Migraine headache


  • Drugs (narcotics, nonsteroidal, anti-inflammatory agents)


LESS COMMON CAUSES OF NAUSEA AND VOMITING NOT TO BE MISSED



  • Myocardial ischemia or infarction


  • Cerebrovascular accident


  • Concussion or postconcussive syndrome



  • Testicular or ovarian torsion


  • Hypertensive encephalopathy


  • Increased intracranial pressure


  • Alcoholic ketoacidosis


  • Diabetic ketoacidosis


  • Glaucoma


  • Functional (bulimia)


  • Diabetic gastroparesis


  • Pyelonephritis

Jun 10, 2016 | Posted by in EMERGENCY MEDICINE | Comments Off on Nausea and Vomiting

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