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DOI:10.2214/AJR.07.3317
AJR 2008; 190:1517-1520
© American Roentgen Ray Society

Clinical Observations

Hyperirritable Stomach as a Cause of Nausea and Vomiting: Clinical and Radiographic Findings

David M. Naeger1,2, Marc S. Levine1, Pooja Renjen1, Stephen E. Rubesin1 and Igor Laufer1

1 Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
2 Present address: Department of Radiology, University of California, San Francisco, Medical Center, San Francisco, CA.

OBJECTIVE. The purpose of our study was to characterize the clinical and radiographic features of the hyperirritable stomach and to determine if it is associated with extraintestinal causes of nausea and vomiting in the absence of gastric outlet obstruction, gastroparesis, or intestinal obstruction or ileus.

CONCLUSION. The hyperirritable stomach was characterized on barium studies in 15 patients by rapid emesis of ingested barium, a collapsed stomach with little or no retained debris or fluid, and normal emptying of residual barium into nondilated duodenum and proximal jejunum. Fourteen (93%) of these 15 patients had extraintestinal causes of nausea and vomiting, and 13 (93%) of 14 with clinical follow-up had marked improvement or resolution of symptoms after treatment. Radiologists therefore should evaluate the stomach and duodenum even after rapid emesis of ingested barium in patients with nausea and vomiting to differentiate a hyperirritable stomach from mechanical or functional gastrointestinal obstruction.

Keywords: barium studies • fluoroscopy • hyperirritable stomach • nausea • vomiting


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