[PBL] Nausea와 vomiting과 신장 질환과의 관계
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분야
hwp1. Nausea & vomiting의 정의
2. Nausea & vomiting의 기전
-Intraperitoneal Disorders
-Extraperitoneal Disorders
-Medications and Metabolic Disorders
3. Labdomyolysis의 pathphysiology
4. Labdomyolysis의 Signs과 symptoms
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.
Disordered gut sensorimotor function also commonly causes nausea and vomiting. Gastroparesis is defined as a delay in emptying of food from the stomach and occurs after vagotomy, with pancreatic adenocarcinoma, with mesenteric vascular insufficiency, or in systemic diseases such as diabetes, scleroderma, and amyloidosis. Idiopathic gastroparesis occurring in the absence of systemic illness may follow a viral prodrome, suggesting an infectious etiology. Intestinal pseudoobstruction is characterized by disrupted intestinal and colonic motor activity and leads to retention of food residue and secretions, bacterial overgrowth, nutrient malabsorption, and symptoms of nausea, vomiting, bloating, pain, and altered defecation. Intestinal pseudoobstruction may be idiopathic or inherited as a familial visceral myopathy or neuropathy, or it may result from systemic disease or as a paraneoplastic complication of a malignancy such as small cell lung carcinoma. Patients with gastroesophageal reflux may report nausea and vomiting, as do some individuals with functional dyspepsia and irritable bowel syndrome.