Why Was the Young Woman Vomiting Everything She Ate or Drank?

🌈 Abstract

The article discusses the case of a 21-year-old woman who experienced persistent vomiting for several months, and how doctors eventually diagnosed her with a rare condition called median arcuate ligament syndrome (MALS) that was likely triggered by a minor car accident she had earlier.

🙋 Q&A

[01] Sideswiped and Whipsawed

1. What happened to the young woman in the car accident?

• The young woman was in a car accident shortly after arriving in Atlanta to start her junior year at Emory University. Another car made an illegal turn and sideswiped her car, causing her to whiplash against the door.

2. What were the initial symptoms she experienced after the accident?

• The next day after the accident, the young woman started experiencing persistent vomiting. Anything she ate or drank would cause her to retch and vomit within minutes.

3. What did the emergency department doctor initially think was the cause of her vomiting?

• The emergency department doctor thought the vomiting was due to a concussion from the car accident, and gave her fluids and anti-nausea medication, but the vomiting did not improve.

[02] Scan After Scan

1. What did the Doppler ultrasound test reveal about the young woman's condition?

• The Doppler ultrasound results were inconclusive, not completely normal but not conclusive for the suspected condition of median arcuate ligament syndrome (MALS).

2. What did Dr. Rome recommend to get a conclusive diagnosis?

• Dr. Rome recommended repeating the CT scan of the young woman's abdomen, taking pictures during both inhalation and exhalation, which ultimately provided a conclusive diagnosis of MALS.

3. How did the nerve block injection help confirm the diagnosis and provide temporary relief?

• The injection of an anesthetic into the celiac plexus nerve bundle, which was being obstructed by the MALS condition, temporarily stopped the young woman's nausea and vomiting, confirming the diagnosis and indicating that surgery could be curative.