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Acute Dilatation Of The Stomach





Category: Uncategorized
Source: Disturbances Of The Heart

This condition is not well understood, nor is its frequence known,
but not a few instances of shock are due to dilatation of this
organ. The shock to the heart may be a reflex one through the
pneumogastric nerves.

It perhaps not infrequently occurs after abdominal operations and is
more or less serious, the symptoms being persistent vomiting, upper
abdominal distention and collapse. The vomiting is of bloody or
coffee-ground material.

Sometimes the ordinary treatment of the collapse and washing out the
stomach save the patient; at other times the patient with this
series of symptoms dies in spite of all treatment.

It has been shown that acute dilatation of the stomach may occur in
pneumonia, and may be one of the causes of cardiac collapse in
pneumonia.

When the condition is diagnosed, the treatment would be that of
shock plus abdominal bandage and washing out the stomach with warm
solutions, if the patient is not too collapsed, or at any rate the
frequent administration of hot water in small quantities.

Sometimes when the stomach is dilated the pylorus becomes
insufficient, and bile regurgitates into the stomach, and is a cause
of the profound nausea and vomiting arid the subsequent collapse. In
these cases

114. Henderson: Am. Jour. Physiol., February and April, 1909. not
infrequently small doses of dilute hydrochloric acid seem to aid the
pylorus to maintain its normal contraction, the regurgitation of
bile does not take place, and the stomach may soon acquire a more
normal muscle tone. Not infrequently when a stomach is in this kind
of trouble and all the foods are rejected, and yet the patient
seriously needs nourishment, a warm, thin cereal, as oatmeal or
gruel or something similar, may be retained. Such patients, as has
been repeatedly stated, need starch as soon as possible, lest an
acidosis develop.

In these vomiting and collapse cases the hypodermic administration
of morphin and atropin will not only stop the vomiting, at least
temporarily, but will also give necessary rest. The dose of morphin
need not be large, and the atropin may prevent nausea from the drug.





Next: Anesthesia In Heart Disease

Previous: Shock



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