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Cyclic vomiting syndrome: contribution to dysphagic infant death

D G Talbert1

  • 1Institute of Reproductive and Developmental Biology, Imperial College School of Medicine, Du Cane Road, London W12 ONN, UK. d.talbert@imperial.ac.uk

Medical Hypotheses
|July 28, 2009
PubMed

Insights

Repetitive vomiting, as seen in cyclic vomiting syndrome (CVS), can cause severe head vein hypertension. This condition shares features with infant death and Shaken Baby Syndrome, highlighting the need for further research.

Area of Science:

  • Gastroenterology
  • Pediatrics
  • Neurology

Background:

  • Vomiting generates high intra-abdominal pressure, driving blood towards the head via the heart's right atrium.
  • Repetitive vomiting, characteristic of cyclic vomiting syndrome (CVS), can lead to extreme venous hypertension in head veins.
  • CVS, described in 1882, remains poorly understood despite recent consensus statements.

Observation:

  • A case study presented symptoms suggestive of CVS in an infant, correlating with age-related increases in abdominal muscle strength.
  • Observed symptoms included swallowing dysfunction, grunting, apnea, reflux, diarrhea, screaming fits, petechiae, skull abnormalities, and staring spells.
  • These symptoms align with potential head vein hypertension, a condition implicated in dysphagic infant death and Shaken Baby Syndrome.

Findings:

  • High intra-abdominal pressure during vomiting can force blood into cranial venous systems.
  • Repetitive vomiting episodes may exceed normal physiological limits, causing sustained venous hypertension.
  • Infant symptoms observed suggest a link between vomiting-induced pressure and neurological/physical manifestations.

Implications:

  • Understanding CVS and its associated venous hypertension is crucial for infant health and potentially differentiating from abusive head trauma.
  • Repetitive vomiting may sensitize the epiglottis, increasing risks of laryngospasm and hazardous intubation attempts, potentially leading to hypoxic brain death.
  • Further research into CVS mechanisms is vital for accurate diagnosis and management, with implications extending beyond gastroenterology.

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