• Ian K Komenaka, Sonal G Gandhi, John B deGraft-Johnson, Eric T Nguyen, and Syed Q Gardezi.
• Department of Obstetrics and Gynecology, New York Methodist Hospital, Buckley 6, 506 6th Street, Brooklyn, NY 11215, USA. en03@hotmail.com
• J Reprod Med. 2003 Feb 1;48(2):124-6.

BackgroundAntiemetic medications are commonly used in the postoperative patient. Despite the lack of evidence-based data, these medications have also been increasingly used in the management of postoperative ileus. This practice is dangerous and increases the risk for morbidity and mortality.CaseA 77-year-old woman underwent an uneventful total abdominal hysterectomy and bilateral salpingo-oophorectomy. The patient developed abdominal distention and vomiting, which were managed with antiemetic medication. The patient continued to vomit, developed esophageal rupture (Boerhaave's syndrome) and died of sepsis and multiorgan failure.ConclusionDespite no scientific evidence for it, the practice of using antiemetic medications and prokinetic agents in the management of postoperative ileus continues. This places the patient at increased risk for completely preventable morbidity, including aspiration, pneumonia, esophageal perforation, prolonged hospital stay and death.

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