Reflex vomiting

Introduction A type of peripheral vomiting. Its characteristics are: there are signs of nausea, not feeling relaxed after vomiting, although the stomach has been empty but still retching. Acute bowel obstruction such as bowel sounds, intestinal type, abdominal muscle tension, tenderness, rebound tenderness and other acute abdomen manifestations of inflammation in the abdominal organs (such as appendicitis, cholecystitis, pancreatitis, peritonitis), biliary ascariasis, intestines obstruction. Vomiting can be a pathological phenomenon, or it can be a protective physiological process, in which toxic substances excreted into the stomach are excreted by vomiting. Patients who are clinically exposed to food poisoning often use vomiting methods to expel the poison before it is absorbed. Intense and frequent vomiting can affect normal eating and digestive activities.

Cause

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, etc.

an examination

Related inspection

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1. Physical examination.: General conditions should pay attention to consciousness, nutritional status, dehydration, circulatory failure, anemia and fever. Abdominal signs should pay attention to gastric type, gastric peristaltic wave, vibrating water and other pyloric obstruction performance, intestinal bowel sounds, intestinal type and other acute intestinal obstruction performance, abdominal muscle tension, tenderness, rebound pain and other acute abdomen performance, in addition, Should pay attention to the presence or absence of abdominal lumps, sputum and so on.

2. Auxiliary examination mainly includes laboratory tests related to inflammation, endocrine metabolism and water, salt and electrolyte metabolism disorders. If necessary, special examinations such as B-ultrasound, X-ray, gastroscope, ERCP, endoscopic ultrasonography, enteroscopy, CT, and magnetic resonance can be selected to determine the diagnosis.

Differential diagnosis

1. Neurological vomiting: This disease is characterized by recurrent vomiting. There is no organic disease as the basis. It does not meet the diagnostic criteria for mental illness. There are no obvious symptoms other than vomiting. Vomiting is often related to psychosocial factors. Clinically, the initial symptoms are common, and careful observation and exploration of motivation factors are often re-diagnosed as other mental disorders. Mostly due to unpleasant environmental or psychological stress, repeated involuntary vomiting episodes usually occur after eating, sudden jet vomiting, no obvious nausea and other discomfort, no appetite, vomiting can eat, more weight Not relieved, no endocrine disorders, often have a rickety personality.

2, pregnancy vomiting: refers to pregnant women during the early pregnancy often appear to eat, loss of appetite, mild nausea and vomiting, dizziness, burnout, known as early pregnancy reaction, usually started in about 40 days after menopause, within 12 weeks of pregnancy, the reaction subsided to life, The impact of the work is small and does not require special treatment. A small number of pregnant women have frequent vomiting, can not eat, leading to weight loss, dehydration, acid-base balance disorders, and serious water and electrolyte metabolism disorders are life-threatening.

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