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• W2146202342 abstract "In children and adolescents, the symptom of vomiting may be associated with a myriad of organic causes, including infections, toxic ingestions, migraine, medication side effect, anatomic obstruction, pregnancy, and increased intracranial pressure.1 Vomiting and other gastrointestinal symptoms may be prominent in psychiatric illnesses as well. They are particularly associated with separation anxiety disorder, panic disorder, somatization disorder, and factitious disorder.2,3 Self-induced vomiting is known to be a frequent method of purging in patients with bulimia nervosa.4 In addition, the practice of self-induced emesis may be present in individuals who do not otherwise meet criteria for diagnosis of an eating disorder. A population-based study of high school girls found that 8% had induced vomiting within the year before the survey as a weight control measure.5 Organic causes have been reported in cases of “psychogenic vomiting.”6,7 However, we believe that this is the first report of a pelvic malignant neoplasm being heralded by self-induced vomiting.The patient is a 13-year-old girl who presented to the emergency department of a tertiary care teaching hospital with chief symptoms (reported by parents) of anxiety and self-induced vomiting. They identified the recent death of an uncle, to whom she had been particularly close, as the precipitating event. Physical examination revealed a girl who appeared anxious and who repeatedly induced vomiting by inserting her hand into her mouth. Abdominal examination revealed no masses, guarding, or rebound. She was given intravenous fluids and sent home and received ranitidine and lorazepam. Twelve hours later, she returned to the emergency department with continued vomiting and hematemesis. She stated, “A piece of me is gone. I'm afraid I'm becoming anorexic.” Physical examination results were unchanged, except that both emesis and stool were now positive for occult blood, and she was mildly tachycardic. …" @default.
• W2146202342 created "2016-06-24" @default.
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• W2146202342 date "1997-05-01" @default.
• W2146202342 modified "2023-09-26" @default.
• W2146202342 title "Self-induced Vomiting as a Presentation of Abdominal Mass" @default.
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• W2146202342 doi "https://doi.org/10.1542/peds.99.5.731" @default.
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