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Nausea and Vomiting

Nausea and Vomiting. History. 61 y o female with recent onset of nausea and vomiting Roux-en-y gastric bypass 2 months ago due to an iatrogenic gastric perforation History of gastric antral vascular ectasia (GAVE) syndrome. GAVE syndrome Watermelon Stomach. Flat mucosal vascular anomalies

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Nausea and Vomiting

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  1. Nausea and Vomiting

  2. History • 61 y o female with recent onset of nausea and vomiting • Roux-en-y gastric bypass 2 months ago due to an iatrogenic gastric perforation • History of gastric antral vascular ectasia (GAVE) syndrome

  3. GAVE syndromeWatermelon Stomach • Flat mucosal vascular anomalies • Cause slow blood loss • Usually responsive to ablative therapy Angioectatic stripes

  4. Anatomy of the Stomach

  5. Pneumoperitoneum

  6. Roux-en-y Gastric Bypass Jejunum Duodenum

  7. Barium Swallow

  8. Findings • No esophageal stricture or dilatation • Mild esophageal dysmotility • Narrowing at the gastro-jejunal (GJ) junction • Delayed emptying of the gastric pouch

  9. Roux-en-y stasis syndrome • Motility disorder in the Roux limb due to the rearrangement of the small bowel • Symptoms: • Postprandial abdominal pain • Nausea • Bloating • Treatment: • Hydration • Medications: Antiemetics and prokinetic agents

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