Scobie B A
Med J Aust. 1983 Apr 2;1(7):329-31.
Recurrent vomiting in adults is characterized by episodes of forceful vomiting which last several hours and recur at inconstant intervals; patients are free from symptoms between episodes. The series comprised 17 male and 14 female patients whose ages ranged from 14 to 69 years. In 10 patients, the vomiting attacks were accompanied by diarrhoea, and in 10 by abdominal pain. Eight patients suffered from bilious vomiting in childhood, and 11 patients had migraine. Five patients gave a family history of recurrent vomiting. Management necessitated a sympathetic approach and balanced investigation. Prochlorperazine administered by injection was helpful in the alleviation of an acute attack, but the possible value of more specific antimigraine therapy remains to be established. Evidence supports a link with migraine, which has an association with other gastrointestinal disorders such as irritable bowel and oesophageal reflux. In cases in which pain is prominent, cholelithiasis should be carefully excluded, but cholecystectomy did not always cure vomiting attacks.
成人反复呕吐的特点是强力呕吐发作，持续数小时，发作间隔不规律；发作间期患者无症状。该系列包括17名男性和14名女性患者，年龄在14岁至69岁之间。10名患者的呕吐发作伴有腹泻，10名伴有腹痛。8名患者儿童期有胆汁性呕吐，11名有偏头痛。5名患者有反复呕吐家族史。治疗需要采取同情态度并进行全面检查。注射用氯丙嗪有助于缓解急性发作，但更特异性抗偏头痛治疗的潜在价值仍有待确定。有证据支持与偏头痛有关，偏头痛与其他胃肠道疾病如肠易激综合征和食管反流有关。在疼痛突出的病例中，应仔细排除胆石症，但胆囊切除术并不总能治愈呕吐发作。
