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What Causes Vomiting And Burning In Esophagus And Throat?
Question: My daughter has episodes of vomiting, with out nausea. There is no warming when they come. SHe has been vomiting for 16 days now. Hospitalized 3 times this episode for IV fluids. She is almost 16. It started about two years ago. SHe has been tested for POC, thyroid, ulcers, neurological issues. SHe has had sonograms of her ovaries and uterus, CT scans of her brain, MRI of brain, endoscopy, and the imaging where you drink the XXXXXXX and they watch it. SHe is on hormones (ogesterol)to stop her menstruation (thinking catemenial CVS) as well as elavil and periactin, she takes Zyrtec for demographia. SHe also has mild von XXXXXXX brand and hemocromatosis. Her doctors ( at Yale) do not know what to do. SHe doesn't respond to reglan or zofram. Her episodes are becoming more frequent and lasting longer. SHe has burning in her esophagus and her throat. SHe cries because she is so hungry. She had an IUD w progesterone placed last month hoping to make things better. It hasn't helped. I also just had metabolic blood work done to test for mast cell disorders as well as angioedema. Still waiting on those tests. I am reading about pyloric stenosis. My daughters vomiting is like something in her stomach pushing the food, liquid, bile right out again. It's like her digestion is working backwards. She has another episode 2 to 3 weeks after he last one has stopped. I am desperate and the doctors have said they are frustrated also. Any ideas.
Brief Answer:
Possibility of Duodenal Web to be considered
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Being a Pediatric Surgeon, I encounter vomiting in various age group ranging from birth till 20 years.
Based on your history of Bilious recurrent vomiting in your daughter , thoroughly worked up including ruling out metabolic disorder , I would consider the probability of following two diagnosis
1. Duodenal Web with Wind sock deformity: there is no complete obstruction, but there is a membrane in occluding the lumen of Duodenal with only a small opening .
2. Malrotation of Midgut: it causes obstruction in 3rd part of duodenum causing bilious vomiting.
One common policy/ consensus I follow as a Pediatric Surgeon: any child or adolescent who present to me with recurrent vomiting and especially if the vomiting is bilious, I would like to rule out above two mentioned surgical causes.
Also from your description of forceful nature of vomiting, as if the gastrointestinal tract is working in reverse it's likely that she has organic upper gastrointestinal obstruction. Above two possibility should be strongly considered and ruled out.
You have mentioned that XXXXXXX study was done.
But this XXXXXXX study is supposed to be under fluoroscopy guidance. Ultrasound may sometimes reveal whirlpool sign which is diagnostic of Midgut Malrotation.
I suggest you to discuss these probability with your daughter Physician.
You can get back to me for any further assistance anytime, will be glad to assist you.
Wishing your daughter speedy recovery.
Take care
Best Regards
Dr Deepak Kishore
MBBS, MS, MCH
Consultant Pediatric Surgeon
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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