Osteopathic manipulative treatment for nausea and vomiting following fine needle aspiration of the neck

Abstract

A 47-year-old woman underwent ultrasound-guided fine needle aspiration of an enlarged lymph node located in the right side of her neck. During this procedure, she began to experience nausea with vomiting, and later, she was hospitalized for intractable symptoms. Upon discharge, the patient required scopolamine to control her symptoms. She followed up with her primary care provider in an outpatient family medicine clinic, and somatic dysfunction was appreciated on her osteopathic structural exam. It was postulated that the patient's symptoms had originated from vagal irritation sustained during the biopsy. Following osteopathic manipulative treatment (OMT), her nausea and vomiting resolved 4 days later, and she no longer required pharmacologic therapy for symptom management. This case report suggests a potential role for somatic dysfunction and the application of OMT in suspected vagally mediated nausea and vomiting.