• Title/Summary/Keyword: Emptying, gastric

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Scintigraphic Evaluation of Gastrointestinal Motility Disorders (기능성 위장관 질환에서 핵의학 검사의 역할)

  • Choe, Jae-Gol
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.1
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    • pp.1-11
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    • 2001
  • Current scintigraphic tests of gastrointestinal motor function provides relevant pathophysiologic information, but their clinical utility is controversial. Many scintigraphic methods are developed to investigate gastrointestinal motility from oral cavity to colon. These are esophageal transit scintigraphy, oropharyngeal transit study, gastric emptying test, small bowel transit time measurement, colon transit study and gastroesopahgeal reflux scintigraphy. Scintigraphy of gastrointestinal tract is the most physiologic and noninvasive method to evaluate gastrointestinal motility disorders. Stomach emptying test is regarded as a gold standard in motility study. Gastrointestinal transit scintigraphy also has a certain role in assessment of drug effect to GI motility and changes alter therapy of motility disorders. Scintigraphy provides noninvasive and quantitative assessment of physiological transit throughout the gastrointestinal tract, and it is extremely useful for diagnosing gastrointestinal motor dysfunction. This article reviews the current procedures, indications, significance and guidelines for gastrointestinal motility measurements by scintigraphy.

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Comparison of the Results in Gastric Carcinoma Patients undergoing Billroth I and Billroth II Gastrectomiesy (원위부 위암에서 위절제술 후 위재건술식에 따른 잔위기능 및 영양 증상학적 삶의 질 비교)

  • Kim, Sung Geun;Kim, Young Kyun;Heo, Youn Jung;Song, Kyo Young;Kim, Jin Jo;Jin, Hyung Min;Kim, Wook;Park, Cho Hyun;Park, Seung Man;Lim, Keun Woo;Kim, Seung Nam;Jeon, Hae Myung
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.16-22
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    • 2007
  • Purpose: The proper reconstruction technique to use after a distal subtotal gastrectomy for a gastric carcinoma, there has been a subject for debated what is the proper reconstruction technique. The aim of this study was to compare the gastricemptying time and the quality of life following both B-I and B-II reconstructions after a distal gastrectomy for a gastric adenocarcinoma. Materials and Methods: We studied 122 patients who had undergone a distal gastrectomy for a gastric adenocarcinoma between June 1999 and July 2002 at our hospital. 51 patients underwent B-I group, and 71 patients underwent B-II group. To evaluate the gastric-emptying time, we analyzed the T1/2 time by means of radionuclide scintigraphy using a gamma camera after ingestion of an $^{99m}Tc$-tin-colloid steamed egg. The nutritional status was measured by the weight change. Postgastrectomy syndrome was evaluated using an abdominal symptoms survey. Dumping syndrome was measured using the Sigstad dumping score. Results: The gastric-emptying time was somewhat delayed in the B-I group after a 6 month period, but there was no difference after 12 months between the two groups. There was less weight loss in the B-I group than in the B-II group (P=0.023). Fewer abdominal symptoms were occurred in the B-I group than in the B-II group. Dumping syndrome occurred less frequently in the B-I group than in the B-II group (P=0.013). Conclusion: In our study, the Billroth I reconstruction led to less weight loss, a better nutritional status, and a better quality of life than the Billroth II reconstruction. We concluded that after a distal subtotal gastrectomy, the Billroth I reconstruction would be considered when the procedure is oncologically suitable.

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Proper Understanding and Application of Gastric Lavage (위세척의 올바른 이해와 적용)

  • Oh, Bum Jin;Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.11 no.1
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    • pp.1-8
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    • 2013
  • Gastric lavage is one of gastrointestinal decontamination methods which have been controversial in the clinical toxicology field for a long time. Expert groups of American and European clinical toxicologists have published the position papers regarding gastric lavage three times since 1997. They recommended that gastric lavage should not be used as a routine procedure in the management of acute intoxication, because they thought that there is no certain evidence of improving clinical outcome by its use. However, the studies they reviewed were not well-controlled randomized trials, which cannot be conducted in the clinical toxicology field due to variability of patients and ethical problems. Therefore, the results from these studies should be interpreted with caution. They also insisted that gastric lavage can be undertaken within 60 minutes of ingestion. The limitation of one hour after ingestion is too arbitrary and may cause a lot of misunderstanding. Formation of pharmacobezoar or gastric hypomotility after ingestion may significantly delay the gastric emptying time so that gastric lavage can be useful even after several hours or more in case of highly toxic substances or severe intoxication. Furthermore, as there are a number of serious intoxication by toxic pesticides with large amount in suicidal attempts in Korea, it seems that gastric lavage may be used more frequently in Korea than in Western countries. When deciding whether or not to use gastric lavage, all the indications, contraindications, and possible adverse effects should be taken into account on the basis of risk-benefit analysis. If the procedure is decided to be done, it should only be performed by well-trained experts.

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Preemptive pyloroplasty for iatrogenic vagus nerve injury in intrahepatic cholangiocarcinoma patients undergoing extensive left-sided lymph node dissection: a retrospective observational study

  • Hwang, Shin;Jung, Dong-Hwan;Jwa, Eun-Kyoung;Kim, Yumi
    • Journal of Yeungnam Medical Science
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    • v.39 no.3
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    • pp.235-243
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    • 2022
  • Background: Intrahepatic cholangiocarcinoma (ICC) of the left liver often shows left-sided lymph node (LN) metastasis. If gastric lesser curvature is extensively dissected, it can induce an iatrogenic injury to the extragastric vagus nerve branches that control motility of the pyloric sphincter and lead to gastric stasis. To cope with such LN dissection-associated gastric stasis, we performed pyloroplasty preemptively. The objective of this study was to analyze our 20-year experience of preemptive pyloroplasty performed in 10 patients. Methods: We investigated clinical sequences of 10 patients with ICC who underwent preemptive pyloroplasty following left hepatectomy and extended left-sided LN dissection. Incidence of gastric stasis and oncological survival outcomes were analyzed. Results: All 10 patients were classified as stage IIIB due to T1-3N1M0 stage according to the 8th edition of American Joint Committee on Cancer staging system. The overall patient survival rate was 51.9% at 1 year, 25.9% at 2 years, and 0% at 3 years. Seven patients showed uneventful postoperative recovery after surgery. Two patients suffered from gastric stasis, which was successfully managed with supportive care. One patient suffered from overt gastric paresis, which was successfully managed with azithromycin administration for 1 month. Conclusion: We believe that preemptive pyloroplasty is an effective surgical option to prevent gastric stasis in patients undergoing extensive left-sided LN dissection. Azithromycin appears to be a potent prokinetic agent in gastroparesis.

A Case of Postviral Gastroparesis in a 7-year-old Boy (바이러스 감염 후 발생한 위마비증 1례)

  • Kim, Eul-Soon;Kim, Jin-Suk;Park, Jae-Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.73-78
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    • 2002
  • Gastroparesis is rare in children and is defined as delayed emptying of gastric contents into the duodenum without mechanical obstruction. We experienced a case of gastroparesis in a 7-year-old boy after a viral illness. He was admitted because of excessive abdominal bloating and diffuse abdominal pain, and was diagnosed by clinical manifestations and measurement of the gastric emtpyting time. He recovered after dietary management and with commbined medication of erythromycin and domperidone in 50 days of illness.

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Acidifier as an Alternative Material to Antibiotics in Animal Feed

  • Kim, Y.Y.;Kil, D.Y.;Oh, H.K.;Han, In K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.18 no.7
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    • pp.1048-1060
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    • 2005
  • Dietary acidifiers appear to be a possible alternative to feed antibiotics in order to improve performance of weaning pigs. It is generally known that dietary acidifiers lower gastric pH, resulting in increased activity of proteolytic enzymes, improved protein digestibility and inhibiting the proliferation of pathogenic bacteria in GI tract. It is also hypothesized that acidifiers could be related to reduction of gastric emptying rate, energy source in intestine, chelation of minerals, stimulation of digestive enzymes and intermediate metabolism. However, the exact mode of action still remains questionable. Organic acidifiers have been widely used for weaning pigs' diets for decades and most common organic acidifiers contain fumaric, citric, formic and/or lactic acid. Many researchers have observed that dietary acidifier supplementation improved growth performance and health status in weaning pigs. Recently inorganic acidifiers as well as organic acidifiers have drawn much attention due to improving performance of weaning pigs with a low cost. Several researchers introduced the use of salt form of acidifiers because of convenient application and better effects than pure state acids. However, considerable variations in results of acidifier supplementation have been reported in response of weaning pigs. The inconsistent responses to dietary acidifiers could be explained by feed palatability, sources and composition of diet, supplementation level of acidifier and age of animals.

Endoscopy after Gastric Surgery: For Each Reconstruction Method, Operator's Point of View (위 수술 전후의 내시경 시술: 재건법에 따른 접근, 수술의 관점)

  • Yilseok Joo;Hyunjin Cho;Sooin Choi
    • Journal of Digestive Cancer Research
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    • v.11 no.2
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    • pp.66-76
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    • 2023
  • Endoscopy is an important noninvasive procedure for patients with gastrointestinal problems. However, surgical techniques are shifting to laparoscopic surgery, and changes in endoscopic findings after laparoscopic surgery differ from those after previous surgical methods. Postoperative endoscopic findings differ from normal anatomical structures, and findings reportedly vary depending on the type of surgical technique. Therefore, we aimed to summarize the surgical and endoscopic findings for each surgical method from the surgeon's point of view. The causes of gastric emptying delay, bleeding, afferent loop syndrome, or anastomosis leakage occurring after gastric cancer surgery can be identified via upper gastrointestinal endoscopy that is relatively less invasive than the surgical method. Regarding postoperative anastomosis leakage, endoscopy can directly evaluate the degree of leakage at the anastomosis site more accurately than computed tomography and enable immediate intervention. As endoscopy is less invasive than the surgical method, patients can be evaluated and treated more safely. However, coordination between the surgeon and the endoscopist is necessary to perform the procedures effectively. Therefore, reviewing the changes in surgical and endoscopic findings is important.

A Case of Dumping Syndrome Following Nissen Fundoplication in an Infant (위저추벽성형술(Nissen Fundoplication) 시행 후 발생한 덤핑(Dumping)증후군 1례)

  • Moon, Jin-Soo;Yang, Hye-Ran;Bae, Sun-Hwan;Kim, Jae-Young;Ko, Jae-Sung;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.92-98
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    • 2001
  • The dumping syndrome has been a known complication of gastric surgery in adults, but it is recognized as a very rare disease in the pediatric population, especially in Korea. We report a case of dumping syndrome in a 10-month-old infant, who underwent Nissen fundoplication for the treatment of gastroesophageal reflux(GER). He was admitted because of aspiration pneumonia, and diagnosed as GER by 24-hour ambulatory esophageal pH monitoring test. For the treatment of GER, Nissen fundoplication was performed. After the operation, symptoms occurred within 30 minutes of meals, such as diaphoresis, palpitation, weakness, abdominal fullness, nausea, and diarrhea. The gastric emptying scan showed very rapid gastric emptying. His oral glucose tolerance tests revealed early-onset hyperglycema followed by delayed-onset hypoglycemia, which was the characteristic finding of the dumping syndrome. We introduced uncooked cornstarch to resolve symptoms and maintain the serum glucose level. After the feeding of uncooked cornstarch, his symptoms subsided and normal oral glucose test was restored. After the six months of treatment, his weight and height were increased dramatically from below 3 percentiles up to the normal range. The dumping syndrome should be considered when an infant suffers from the feeding difficulties after the gastric surgery like Nissen fundoplication, and the diet therapy including uncooked cornstarch could be applied as an effective measure.

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